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Primary Procedure vs Secondary Procedure

  1. Default Primary Procedure vs Secondary Procedure
    Medical Coding Books
    Lap Chole 47563 was performed, and was the reason for the surgery. The surgeon ended up doing an extensive lysis of adhesions 44180. These two can't be billed together. The 44180 has a higher RVU, but can I code just 44180 when 47563 was the reason for surgery or "primary procedure"?

    Thank you for your help!

  2. #2
    Columbia, MO
    You will have to charge the chole since that is the procedure supported by the diagnosis. The lysis of adhesions was an incidental procedure and is bundled. If the documentation supports extensive for the lysis you can use a 22 modifier on the lap chole.

    Debra A. Mitchell, MSPH, CPC-H

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