I usually increase the amount for the lap chole and put a 22 modifier on it. If it's commercial insurance I write a short note to go with the op stating that I am requesting greater reimbursement for the lysis of adhesions and send the op note along with it. It usually generates around $200 more for the claim. If it's Medicare I put a 22 on it, wait for payment and then send in a redetermination and they usually pay.
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