Wiki Adhesiolysis at time of C-Sec sep providers

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bonnienorth55

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I have a case where our provider was performing a C-section and ended up needing to call in another provider to perform lysis of adhesions of the bladder. Our provider never punctured/did anything with the bladder; the urologist came in, did their part, then our provider stepped back in to finish the remaining portion of the C-section. (Baby was already delivered before urologist was paged). We are billing the global C-section code 59510. Would this warrant a modifier 22 on our provider's claim? Also wondering how the urologist would be billing this service.

Thank you for any input! :)
 
Mod -22 always comes down to the documentation. What was the additional work required by the OB if a urologist was called in? If documentation supports substantial additional work, then -22 is appropriate.
Here are some MACs guidelines regarding -22.

I am not very familiar with urology procedures, but 58740 might be appropriate for the urologist or 44005 depending on the location of the adhesions.
 
csperoni said:
Mod -22 always comes down to the documentation. What was the additional work required by the OB if a urologist was called in? If documentation supports substantial additional work, then -22 is appropriate.
Here are some MACs guidelines regarding -22.

I am not very familiar with urology procedures, but 58740 might be appropriate for the urologist or 44005 depending on the location of the adhesions.
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Thank you for that information, you have a point with the extra work part since the urologist was called in and therefore would not be supported by the documentation. It's been a tricky case for sure! The urologist is now inquiring with us as far as the coding since they thought we should unbundle the global OB so both of our providers can bill 59514-62.
 
When I checked, I was actually surprised to see that -62 wa valid on 59514. However, you indicated the urologist was not even present when the baby was delivered. I really don't see this as being a co-surgery for the C/S. I call these joint surgeries rather than co-surgeries - where each physician is doing their own separate part.
I see this as 59510 for ob. -22 only if documentation supports.
Urologist possible options:
58740 if adhesions involved adnexa
44005 if adhesions involved intestines
unlisted 53899 if adhesions are from bladder to elsewhere
 
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