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lysis of adhesions bundled or not?

  1. Default lysis of adhesions bundled or not?
    Medical Coding Books
    patient had arthroscopic rotator cuff repair, subacromial decompression & lysis of adhesions, Im not sure if the lysis should be bundled?

    intrarticularly, there was found to be a massive rotator cuff tear with supraspinatus tendon retracted up to the level of the glenoid. I t was therefore elcted through a direct lateral portal which would later be used for subacromial decompression after idenitifying an 18 gauge spinal needle, a 4.5 shaver was introduced to debride the synovium adhesions. a bipolar radiofrequency wand was used to release the rotator cuff subscapular interval and adhesions underneath and adhesions from the glenoid surface and the articular surface of the rotator cuff supraspinatus portion. The infraspinatuss was also debrided and adhesions were removed with the shaver and bipolar radiofrequency wand as well as the subscapularis tendon.
    Then it goes on to describe subacromial decompression & RC repair.

    I think it's bunded???


  2. #2
    Portland, Maine
    Yes, this is bundled. We have been reimbursed occasionally for lysis of adhesions but only by applying a 22 modifier IF the documentation supports that the adhesions were such that it complicated the surgery or took extensively longer than the surgery would normally take. It's really difficult to get the additional payment from the insurance companies.

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