tci General Surgery Coding Alert - 2023 Issue Q2

You Be the Coder: Use Modifier 22 Instead of ‘Separate Procedure’

Question: During a cholecystectomy using the laparoscope, the surgeon documented spending 75 minutes lysing “very dense, adherent” adhesions using sharp dissection. Should we add 44180 to the cholecystectomy code for the services provided? Texas Subscriber Answer: No, you should not code 44180 (Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)) in addition to the code for the primary procedure, 47562 (Laparoscopy, surgical; cholecystectomy). Here’s why: National Correct Coding Initiative (NCCI) bundles the codes with 44180 as a column 2 code for 47562 with a modifier indicator of “0,” meaning that you can never override...

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