cpt code for adhesiolysis of adhesions

mrolf

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Scenario: Patient has RUQ pain and has been to the ED multiple times and receiving large quantities of narcotics. Ultrasound & HIDA scan negative. Surgical interventation warranted. Surgeon did a laparoscopic cholecystectomy and laparoscopic appendectomy and patient had extensive adhesions between the rt lobe of the liver and the anterior abdominal wall which were taken down sharply. What CPT codes can be used?? CPT 47562 & 44970. What CPT code for the adhesiolysis of extensive adhesions??
Any help would be appreciated. Thanks.
 

acbarnes

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I agree LOA is bundled. Our practice has found to add modifier 22 the note needs to state additional time and effort (usually needs to state as least 1+ hours added to typical operative time). Also, any reasoning for extensive adhesions such as previous surgerical histories, hostile pelvis, and inflammatory process. Lately, modfier 22 have been going to second level appeals to be paid because insurance companies are getting tougher on paying additional.

Anna Barnes, CPC, CEMC
 
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