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Wiki Exp. Laparotomy & bso
- Thread starter bgrenfell
- Start date
cmcgarry
Guest
This would be unbundling - an exploratory laparotomy is not billed once a definitive procedure is performed.
Then shall we assign 58720 append modifier-59 for adhesiolysis and modifier -22 for increased procedural services (since exploratory laparotomy involves exploration (bieng the first intention of the surgery)complex, demanding time, efforts and physical and mental work,eg explore for lymphnodes or other organ status or some coexisting pahtology.
I wish I could get the feed back for this query of modifer addendation.
I wish I could get the feed back for this query of modifer addendation.
mitchellde
True Blue
unless the lysis of adhesions is extensive and documeted as having therapeutic value to the patient, rather than to clear the way for the physician, you cannot bill anything additional. Adhesions are normal and most surgeons must take down the adhesions as a part of the surgical service. To use the 22 modifer you will need really great docuemntation to support that the procedure was more intensive and involved than what it should have been. Just having started as an exploratory that becomes a definitive procedure in not enough.
Yes, indeed I understand. But the adhesions in pelvic region and the crowding anatomy and the histological structures of all those surrrounding uterine adenexal region are proned for complex and incarcerated adhesions with prevalence of infections in those structures; for eg appendecitis, PIDS, salpingitis, pelvic peritonitis and so on. Some of them pass unnoticed even.
One story about a surgery that took place in one of Middle East countries: a famous Consultant Surgeon was given a verdict for getting his testes removed, just because of a few ovarian tissues just seen on a cyto path study of the appendectomy specimen. This is just to be aware of extent of the impact of adhesiolysis in those areas .
I can agree with filmy flimsy adhesion like in skin area or vulval adhesion due to infection as trivial ones.
Well, as you said if the doctor documents the extent of the procedures then it can be.
Thank you
One story about a surgery that took place in one of Middle East countries: a famous Consultant Surgeon was given a verdict for getting his testes removed, just because of a few ovarian tissues just seen on a cyto path study of the appendectomy specimen. This is just to be aware of extent of the impact of adhesiolysis in those areas .
I can agree with filmy flimsy adhesion like in skin area or vulval adhesion due to infection as trivial ones.
Well, as you said if the doctor documents the extent of the procedures then it can be.
Thank you