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Wiki lysis of adhesions-Reviewing a lap hernia

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Christine38

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Reviewing a lap hernia repair that took place with a lysis of adhesions. I see that according to the NCCI - during a lap procedure the lysis would not be reported separtely, but do we know of anything to support it being reported separtely if it takes 3 hours. The hernia repair takes on average 3-4hours....wouldnt the time of an additional 3 hours provoke separate billing?
Thank you.
 
You could use a 22 modifier and submit the claim with a very detailed operative report that explains the necessity of this billing. A letter from the surgeon should be sent also. Depending on the carrier, you may get this paid.
 
I agree with Anastasia. Included in the note should be an explanation of how much additional time was spent on the lysis of adhesions and why.
 
We also use the 22 mod for lysis of adhesions. We have no luck getting it paid though - yes sometimes it takes 3 hours and lots of time .... i don't know why they won't pay - they are so hell bent on the bundling factor and don't care about the extra time/complexity

we've sent records, letters, appeals... nothing...
 
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