Wiki Help with Take-down of hepatic flexure

[Patricia Donegan]

I have a surgeon who always lists "take-down" of hepatic flexure when doing
a partial colectomy (44140). I do NOT see any code for this , and honestly, think it's probably bundled into the colectomy. I do see a code for take-down of splenic flexure, but thats not what he's doing. Also, he recently did a partial colectomy (44140) and a liver resection (47120) for metastatic ca., and also now wants to add the take-down of hepatic and lysis of adhesions. Again, I feel they are bundled. Can anyone offer any help?? Am I missing any codes?? My thinking is that codes for colectomies and liver resections likely inlcude hepatic flexure take-downs.
thanks

 

[monbel]

inclusive to the primary procedure

 

[kajalgaonkar16]

Yes, you are correct. The hepatic flexure takedown is bundled into the primary procedure and is not separately reportable. As far as lysis of adhesions is concerned, if the documentation supports an extensive adhesiolysis or a time consuming adhesiolysis, you can always append modifier 22 to the major procedure code.