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Extensive lysis of adhesions, pericardial cavity with CABG

  1. #1
    Richardson, TX
    Default Extensive lysis of adhesions, pericardial cavity with CABG
    Medical Coding Books
    Is there a code for lysis of adhesions, entire pericardial cavity done with CABG? Physician states this lysis took 1 hour to complete. Should I just add a 22 modifier to my CABG code? See below:

    Left pleural chest tube was placed, and now we opened the pericardium. Upon
    starting to open the pericardium, I realized the patient is completely stuck
    in entire pericardial cavity. This is most probably due to previous
    infarctions and previous coronary events and subsequent Dressler
    syndrome/pericarditis. There dense adhesions throughout the entire pericardial
    cavity. It took me about 1 hour to be able to free up some of the wall of the
    heart starting on the right side

    OR is this just included in the procedure?

    Any advice or tips are greatly appreciated!!!!
    Julie Graham, BA, CPC, CCC

  2. #2
    I would go with the 22 modifier.. Esp since he documents the 1 hour .. I have do it before and they ask for notes but it gets paid 90% of time

  3. #3
    Richardson, TX
    Thank you very much!
    Julie Graham, BA, CPC, CCC

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