Wiki Modifier 57 - abdominal adhesions

[tracylc10]

Pt having 58720 and during surgery realized that the pt had dense pelvic and abdominal adhesions. They used 58720-57 and 58740. I am not sure that modifier 57 is correct. Lysis of adhesions is usually an included procedure unless it adds significant additional work. The notes state that they were dense and it seemed like more work. Would you use modifier 22 with 58740 instead of 57 with 58720?

 

[CodingKing]

Modifier 57 is an E&M only modifier for decision for surgery on day of or day before a major procedure. For lysis of adhesions its modifier 22 on the surgical line and drop to paper with operative report. You would not bill the lysis separately. Just make sure the documentation is there of dense and or/ excessive lesions and how much time it added to the procedure, etc. Someone will then determine if they consider it intense enough to pay more.

 

[tracylc10]

Modifier 57 is an E&M only modifier for decision for surgery on day of or day before a major procedure. For lysis of adhesions its modifier 22 on the surgical line and drop to paper with operative report. You would not bill the lysis separately. Just make sure the documentation is there of dense and or/ excessive lesions and how much time it added to the procedure, etc. Someone will then determine if they consider it intense enough to pay more.

Thank you. That is what I thought.