Ob-Gyn Coding Alert

Question: I need a CPT code for lysis of adhesions after cesarean. The patient had an elective c-section after two previous c sections. The ob-gyn arrived after the delivery. The patient had adhesions of the uterine muscle to the left anterior including fascia and rectus muscle adhesions. She had adhesions of the old uterine to the left pelvic sidewall, and the bladder flap was densely adherent to the lower portion of the old intra-abdominal incision and the left sidewall. These adhesions were bluntly and sharply removed by electrocautery and sharp dissection.

New York Subscriber

Answer: The only code you can report is the general lysis code 58740 (Lysis of adhesions [salpingolysis, ovariolysis]) if the payer will reimburse your ob-gyn separately from the physician who performed the cesarean. Remember, you'll need to add modifier 52 (Reduced services) because your ob-gyn did not open the surgical site. If the physician who performed the cesarean was part of your practice, this may have an impact with the payer.
 
Note: You cannot code the procedure you describe as enterolysis (44005). Your situation does not constitute scar revision either, so avoid 13100-13102.