Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
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tci General Surgery Coding Alert - 2002 Issue 3
Reader Question: Lysis of Adhesions
Question: While removing an adnexal mass, we encountered extensive adhesions from the patient's bowel wall to the abdominal wall. A general surgeon was called in to lyse the adhesions, which took three hours. The patient was already open, and the surgeon did not participate in the rest of the surgery. Which modifier should we use?
California SubscriberAnswer: Lysis of adhesions (44005, Enterolysis [freeing of intestinal adhesion] [separate procedure]) normally carries 25.02 relative value units (RVUs). The situation described is unusual. Additional payment may be warranted due to the additional time spent and work performed by the surgeon, but...
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