47600 with 44005 HELP

laurijean

Networker
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46
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0
I had a provider see a patient in the ER , ended up having to go to surgery. The abdomen was opened, the abdomen is inspected and the small bowel eviscerated. A small adhesive band is dissected and cleared. the SB obstruction is relieved. She also has chronic cholecystitis and decided to perform an open cholecystectomy at that time.
I coded 44005 with 47600, CCI says I can not bill these two codes together, Does any one have an alternative codes so my provider is paid for his work?
 

thomas7331

True Blue
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3,157
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Exploration and lysis of adhesions is considered a component of all open abdominal procedures. Since the code 44005 is designated in CPT as 'separate' procedure, it can never be billed together with 47600.

Per NCCI guidelines, ' if a provider performs extensive and time-consuming enterolysis in conjunction with another intra-abdominal or pelvic procedure, the provider may append modifier 22 to the CPT code describing the latter procedure.' If the documentation supports this and you choose to use the modifier, you'll just need to submit the operative notes along with the claim and the payer will determine that amount of additional payment that is warranted for the extra work.
 
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