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Thread: Multiple small bowel resections

  1. #1
    Join Date
    Apr 2007

    Default Multiple small bowel resections

    AAPC: Back to School
    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.

  2. #2
    Join Date
    Apr 2007
    Northeast Kansas AAPC


    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

  3. #3


    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.

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