Wiki Multiple small bowel resections

[phoover1955]

Medicare PT.....doc did 4 hr exp lap w/loa...he wants up charge w/22-modifier. also did small bowel resection x 2....can we charge x 2 for this??
and if you bill the exp lap, doesn't that get bundled to the LOA or vice versa??

Thanks, Pat H.

 

[lindacoder]

I would charge 44120 and 44121 for the small bowel resections and up the charges with a 22 modifier, send letter and op note noting the extensive lysis of adhesions

 

[bran1120]

I would need to read the op note to determine proper coding. Were the SBR x 2 caused by the LOA or were the resections planned? If the SBR were medically necessary then I would agree with the above post. If the resections were due to iatrogenic injuries then I would code the LOA w/a 22 modifier. You can check the edits but I believe the LOA is bundled with the SBR x 2 (44120, + 44121) and the ELAP is bundled as well.