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Thread: Intraoperative Help by General Surgeon to a OB/GYN

  1. #1

    Question Intraoperative Help by General Surgeon to a OB/GYN

    AAPC: Back to School
    Hi All,

    I need help with this scenario. My doc, who is a general surgeon, was called into a surgery by an OB/GYN who was performing a hysterectomy and ran across extensive adhesions. The OB/GYN needed our doc to handle a small bowel resection, he did the resection and anastomosis along with lysis of adhesions. He then handed off back to the OB/GYN, she continued. My surgeon was then called upon again about one and a half hours later. He scrubbed in and performed lysis of adhesions around the sigmoid colon.
    What can I bill for this? Only the bowel resection of 44120? Or can I bill anything for the second trip to the OR? Also, do I need to use a modifier for this, like a 54, since he didn’t do pre-op and won’t be doing any post op?? Thanks for your thoughts.

  2. #2


    I would just bill for the colon resection. Lysis of adhesions is typically included in the main procedure. If the provider performed "extensive" lysis of adhesions you increase your fee and add modifier 22 to your procedure----but only if the documentation can back it up.


  3. #3


    Oh 22 modifier....that makes sense. What about the modifier 54? Do I use it in cases as these??

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default If truly NO post-op

    If your general surgeon is TRULY doing no post-operative care, then, yes, you should also use the -54 modifier. But if your general surgeon looks in on the patient while still hospitalized to assess recovery, then s/he HAS performed some postoperative care (even if not having patient come to the office later during recovery) and I wouldn't use the -54 modifier.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  5. #5


    Yes it does help, thank you!

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