Wiki Billing for Adhesions with Lap Cholecystectomy

[twobcas@yahoo.com]

Our surgeon wants to bill for lysis of adhesions(44180 seperate procedure) AND the laparoscopic cholecystecomy(47562). He put in the operative note "This was a very extensive lysis of adhesions. It was complex." and then continues on with the description of removoving the gall bladder.
Does this support billing the lysis of adhesions and the main surgery code?
If so would I append a 59 modifier?

 

[Lisa Bledsoe]

Adhesions are bundled. I would code 47562-22 increase the fee by 20-25% and submit the claim with op notes.

 

[FTessaBartels]

Extensive Lysis of Adhesions

We require our surgeons to document the amount of time spent in lysis of adhesions before they could begin the primary procedure. We add the -22 modifier only if it took 45 minutes or more for lysis alone. (And, yes, we check the anesthesia records to verify total time for procedure.)

Hope that helps.

F Tessa Bartels, CPC, CEMC