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How to bill 44180 and 58661

  1. #1
    Default How to bill 44180 and 58661
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    Have a doctor that performed both 44180 and 58661, they are bundled codes, what is the proper way of handling this?

  2. #2
    Location
    Indianapolis
    Posts
    187
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    Even though the provider performed both the 44180 and the 58661, the 44180 should not be reported (in most cases). The 44180 is considered a "separate procedure" which means it is only reported if it is not performed with another major procedure or part of another major procedure. So, the 58661 should be the only service reported as it already includes the RVU's (and payment) for the 44180.

    To clarify my earlier "in most cases", in rare cases some payers will pay for the lysis of adhesions (44180) in addition to the other major surgical procedure if the lysis of adhesions was severe, extremely time consuming, etc. However, the documentation will have to support this service and you will often receive a denial of the initial claim and have to fight to attempt to get the service paid. Good luck!
    Chandra L. Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPPM, CRC, CCS, CPC-I, CANPC, CCC, CEMC, CGSC, CFPC, CIMC, COSC
    2012-2013, 2016 President, AAPC Indianapolis Indiana Chapter
    2013-2015 AAPC National Advisory Board Member
    chandra.stephenson@gmail.com

  3. #3
    Post
    Quote Originally Posted by clsteph1 View Post
    Even though the provider performed both the 44180 and the 58661, the 44180 should not be reported (in most cases). The 44180 is considered a "separate procedure" which means it is only reported if it is not performed with another major procedure or part of another major procedure. So, the 58661 should be the only service reported as it already includes the RVU's (and payment) for the 44180.

    To clarify my earlier "in most cases", in rare cases some payers will pay for the lysis of adhesions (44180) in addition to the other major surgical procedure if the lysis of adhesions was severe, extremely time consuming, etc. However, the documentation will have to support this service and you will often receive a denial of the initial claim and have to fight to attempt to get the service paid. Good luck!
    Since 44180 is bundled procedure, I would rather add modifier 22 with 58661 if the lysis of adhesions was extremely time consuming and difficult.
    Girish Dadhich, CPC

  4. #4
    Location
    Idaho Falls, Idaho
    Posts
    197
    Default
    When coding lysis of adhesions, if they were done to get to the site of the surgery (to get to the ovary), you can not code the lysis seperatly. If they notice ab adhesions that have nothing to do with the surgery and just incidentially removed them, you still can't code it seperatly. This procedure is usually always included in the surgical package. Now, lets say that, for example, a laprascopic hyst was attempted, they spent 30 mins taking down heavy adhesions, and it caused the surgery to be abnormally difficult, and it is documented correctly, then you can code the lysis.
    Tesja Erickson, CPC, CPMA COBGC, CEMC
    The Coding Surgeon
    Medical Documentation & Coding Consultant
    codingsurgeon@tesja.com
    2012 AAPC Idaho Falls Chapter President
    2011 AAPC Idaho Falls Chapter President-Elect

  5. #5
    Default
    Thank you for the help. That is what I told the other person that is trying to code this.

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