midnight1995
Networker
This is the first time seeing this type of Surgery: The OBGYN made an emergent call to our Provider whose prime specialty is Gastroenterology/ General Surgeon.
CPT that is billed 59510 but this is not allowed for Co-Surgery (Modifier 62). If anyone has any guidance on how the below should be billed by the Gastro provider, greatly appreciated.
Op note:
Was called emergently by OBGYN during active repeat C-section because of dense adhesions of the bowel to the uterus and increased bleeding. Came in IntraOp consult and assisted with lysing adhesions off the uterus and helping her to complete her C-section
Operation: Open lysis of adhesions
Findings: Loop of small bowel and likely sigmoid colon adhered to the uterus
Tecnique:
I was called and intraoperative the middle of C-section that was already in progress for intraoperative consultation. There were some loops of bowel on the left side of the uterus that were adhesed and ingrown somewhat into the uterine muscle. I was asked to help assist in lysing adhesions and removing the bowel off of the uterus to help complete the C-section. When I arrived the abdomen was ready open typical Pfannenstiel and there were some macerated and sliced rectus muscle that were attached to the uterus.
There was also some bowel that was attached to the left uterine wall. Adhesions to the uterus and bowel were lysed sharply using Metzenbaum scissors. The bowel was examined for any enterotomies and there were none there may have been some slight serosal tears that were oversewn with Vicryl sutures. The bowel was then placed back into the abdomen. I than helped assist the OBGYN to complete her C-section and retraction of the rest of the muscle and she proceeded to open the uterus and I helped her in delivering the baby and assisted in help closing the in help closing the uterus. At that point after hemostasis was achieved I left her to complete the operation and closed the abdomen.
CPT that is billed 59510 but this is not allowed for Co-Surgery (Modifier 62). If anyone has any guidance on how the below should be billed by the Gastro provider, greatly appreciated.
Op note:
Was called emergently by OBGYN during active repeat C-section because of dense adhesions of the bowel to the uterus and increased bleeding. Came in IntraOp consult and assisted with lysing adhesions off the uterus and helping her to complete her C-section
Operation: Open lysis of adhesions
Findings: Loop of small bowel and likely sigmoid colon adhered to the uterus
Tecnique:
I was called and intraoperative the middle of C-section that was already in progress for intraoperative consultation. There were some loops of bowel on the left side of the uterus that were adhesed and ingrown somewhat into the uterine muscle. I was asked to help assist in lysing adhesions and removing the bowel off of the uterus to help complete the C-section. When I arrived the abdomen was ready open typical Pfannenstiel and there were some macerated and sliced rectus muscle that were attached to the uterus.
There was also some bowel that was attached to the left uterine wall. Adhesions to the uterus and bowel were lysed sharply using Metzenbaum scissors. The bowel was examined for any enterotomies and there were none there may have been some slight serosal tears that were oversewn with Vicryl sutures. The bowel was then placed back into the abdomen. I than helped assist the OBGYN to complete her C-section and retraction of the rest of the muscle and she proceeded to open the uterus and I helped her in delivering the baby and assisted in help closing the in help closing the uterus. At that point after hemostasis was achieved I left her to complete the operation and closed the abdomen.