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lysis of adhesions-Reviewing a lap hernia

  1. Lightbulb lysis of adhesions-Reviewing a lap hernia
    Medical Coding Books
    Reviewing a lap hernia repair that took place with a lysis of adhesions. I see that according to the NCCI - during a lap procedure the lysis would not be reported separtely, but do we know of anything to support it being reported separtely if it takes 3 hours. The hernia repair takes on average 3-4hours....wouldnt the time of an additional 3 hours provoke separate billing?
    Thank you.

  2. #2
    You could use a 22 modifier and submit the claim with a very detailed operative report that explains the necessity of this billing. A letter from the surgeon should be sent also. Depending on the carrier, you may get this paid.

  3. Default
    I agree with Anastasia. Included in the note should be an explanation of how much additional time was spent on the lysis of adhesions and why.


  4. #4
    We also use the 22 mod for lysis of adhesions. We have no luck getting it paid though - yes sometimes it takes 3 hours and lots of time .... i don't know why they won't pay - they are so hell bent on the bundling factor and don't care about the extra time/complexity

    we've sent records, letters, appeals... nothing...

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