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Lysis of adhesions-I have two


Columbus, Ohio
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I have two patients, both have a right VATS procedure with wedge resections (32657) but both of them had extensive lysis of adhesions. I see with a thoracotomy that there's a specific code for open intrapleural pneumonolysis (32124) but nothing under VATS. Should I bill 32657-22 as long as there's documentation?

Part two: If one patient had a wedge done on the right upper, right middle, and right lower does that constitute the term "multiple" or is that referring to if the patient had multiple resections in the same lobe.

(gee, can you tell that I'm new at this!!)



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I normally do not bill for the lysing of adhesions but if it is documented that it took a great deal of time, etc. then possibly a 22 can be appended.

And without reading the op note and researching a bit further, I'm not 100% sure but I believe that if the wedge resections were done via VATS then you would only bill 32657 once - the CPT code actually states, wedge resection of "lung", single or multiple

Hope this helps some...