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Thread: Billing for Adhesions with Lap Cholecystectomy

  1. #1

    Default Billing for Adhesions with Lap Cholecystectomy

    AAPC: Back to School
    Our surgeon wants to bill for lysis of adhesions(44180 seperate procedure) AND the laparoscopic cholecystecomy(47562). He put in the operative note "This was a very extensive lysis of adhesions. It was complex." and then continues on with the description of removoving the gall bladder.
    Does this support billing the lysis of adhesions and the main surgery code?
    If so would I append a 59 modifier?

  2. #2
    Join Date
    Apr 2007
    Greeley, Colorado


    Adhesions are bundled. I would code 47562-22 increase the fee by 20-25% and submit the claim with op notes.
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Join Date
    Apr 2007
    Milwaukee WI

    Default Extensive Lysis of Adhesions

    We require our surgeons to document the amount of time spent in lysis of adhesions before they could begin the primary procedure. We add the -22 modifier only if it took 45 minutes or more for lysis alone. (And, yes, we check the anesthesia records to verify total time for procedure.)

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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