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Wiki Some advice please

nrichard

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Pensacola, Fl
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Dr. performs
1. Exploratory laparotomy w/ extensive lysis of adhesions (approximately 3 hours)
2. Resection of short segment right colon.
3. Repair of multiple enterotomies
I know I can't bill the laparotomy or the enterolysis, because they are bundled w/ the resection of the colon. (This I'm sending w/ a -22 modifier) My question is can I bill the repair of the enterotomies. They were a direct result of the lysis of adhesions. Op note reads like this;
I proceded slowly and carefully w/ dissection; however, the small bowel was densely adherent to the anterior abdominal wall in this location and approximately 3 or 4 enterotomies were created. I closed them each immediately with interrupted 3-0 silk sutures.
My thought is I can't bill this, but I wanted to double check, because for some reason I keep second guessing my self. :confused:
 
Hi,

Please dont bill the repair separately as they are the accidental enterotomies when performing the major procedure. Append modifier 22 with primary procedure.

Regds,
Joe:)
 
Thanks

That's exactly what I was thinking, but like I said I was second guessing myself. Guess I haven't had enough coffee this morning ;)
 
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