Wiki Lysis of adhesions 44005

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mconnolly

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I have a surgeon who insists on billing 44005 when doing other surgeries, specifically hernia surgeries. Can anyone tell me is it appropriate to just bill the lysis of adhesions when the RVU's are higher than the other codes that are being billed. Our problem is, Ins is paying on lower RVU surgeries and not paying 44005 for being global even though the RVU's are higher. I would appreciate any input on this matter. Op report always states the original surgery (hernia) and also having to do the lysis of adhesions. My thought also is to put a 22 modifier on the hernia but do we really get paid for that?:confused:
 
Lysis of adhesions is considered to be a normal part of the procedure and is bundled. If the surgeon has to do an LOA that is beyond the norm then you can bill the hernia repair with modifier 22 as long as the physician dictates the reason the procedure was complex.
 
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