First, I assume you mean that you coded 44950 (open appendectomy) and 44180.
44180 is laparoscopic lysis of adhesions and is considered a "separate procedure." This means it cannot be coded unless it it truly separate from other procedures performed in the same operative session.
Your auditor is correct.
However, if you have documentation of considerable effort in performing the lysis (I'm talking an additional hour or more over and above the time required for the primary procedure) you could append a -22 modifier to your main code.
Of course, in either case, you will need to send the operative report with your appeal.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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