My surgeon went in laparoscopically to repair an incarcerated incisional hernia. He encountered extensive adhesions which were very dense and he ended up doing very tedious dissection of the adhesions which took 1.5 hours in addition to the hernia repair. Lysis of adhesions took considerable more time than the hernia repair. Can the surgery be coded 44180 (22), or should I use the hernia repair code and append a 22. I feel like he would get a more fair reimbursement by using 44180 (22). Opinons please? Thank you!