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Thread: billing c-section with lysis of adhesions

  1. #1

    Default billing c-section with lysis of adhesions

    AAPC: Back to School
    do you know if you can bill separately for lysis of adhesions when done at same time a c-section?

  2. #2


    You can bill the two together, but most payers will deny the lysis of adhesions inclusive per NCCI guidelines. The use of a modifier is not allowed. I hope this helps.....

  3. #3


    Great, thank you!

  4. #4


    In my openion:
    Cesarean section is a comprehensive and an unique service. Adhesions on the way of C-section for exposing the uterus and the uterine incisional area becomes a component of C-section performance. In that case the adhesiolysis cannot be reported separately, how ever, adhesiolysis is not a normal course of normal C-section.
    But having said that it is not an easy or less time consuming procedure.
    It requires extensive work and time to perform.

    So it merits for modifier-22 definitely, if not accepted for the adhesiolysis.
    With a detailed and pertinent surgical report, it should be accepted either of these.

    My request to GR8 is: why modifier not allowed? Could you please give the reason with reference.

  5. #5
    Join Date
    Apr 2007
    San Diego, California


    CCI Edits - 44005 is bundled with 59510. It's a column 2 code for 59510 and -51/-59 are not allowed to distinguish 44005 from 59510.

    Kimberly A. Sherman, MA, CPC
    Multi-Specialty Physician Coder/Entrepreneur

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