I normally do not bill for the lysing of adhesions but if it is documented that it took a great deal of time, etc. then possibly a 22 can be appended.
And without reading the op note and researching a bit further, I'm not 100% sure but I believe that if the wedge resections were done via VATS then you would only bill 32657 once - the CPT code actually states, wedge resection of "lung", single or multiple
Hope this helps some...
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