cci edits

cooper1

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I've just started coding for a new general surgery office. When they do a lap cholecystectomy they are billing 47562 and 44180-59. I know this is a cci edit but they said they have been doing it for years and get paid on it. I don't code for it if it's a cci edit. I'm wondering what others do.

Thanks

Tracey
 

mbort

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bypassing the CCI edits with the 59 just to get paid for it really isnt a good idea.

Unless you have substantial documentation to support the use of the 59 modifier (which you more than likely do not) then it really and truly is not advised.
 

cooper1

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This is what I told them but they are shocked that I won't code for it.

Thanks

Tracey
 
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Only when Extensive Lysis documented

We have used this approach ONLY when an extensive lysis of adhesions was performed. We required the surgeon to document the amount of time required for the lysis of adhesions, and if it's over an hour we'll use the 44180-59.

It's not often that this requirement is met.

F Tessa Bartels, CPC, CPC-E/M
 

aguelfi

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I agree w/ Tessa. I will use it w/ a 59 but ONLY if it' over an hour and well documented how difficult the adhesions were. Otherwise I'll append I might append a 22 on the lap if the documention isn't specific enough but still deserves more payment.
 
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