Medicare Compliance & Reimbursement - 2020 Issue 11
Reader Questions: Beware Adhesiolysis Bundles
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Article Overview
This article answers a reader question about surgical coding when extensive adhesiolysis is documented during a splenectomy. It explains the general bundling issue under NCCI edits, identifies the primary and related procedure codes involved, and discusses the type of documentation that may support reporting increased procedural services. The content is relevant for coders, billers, and reimbursement staff working with general surgery and outpatient surgical coding.
Why This Topic Matters
It helps coding professionals recognize when a separately reported procedure may be bundled into a primary operation and understand the documentation considerations that can affect claim reporting.
Article Sections
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Question
A reader asks about coding a splenectomy case in which extensive adhesions required additional operative effort to complete the procedure.
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Answer
The response addresses the bundling relationship between the procedures and notes the general reimbursement approach discussed in the article.
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NCCI edit guidance
This section summarizes the coding edit concept referenced in the article and its effect on reporting the related procedure pair.
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Documentation and modifier consideration
The article discusses the type of operative documentation that may support consideration of increased procedural services for added work.
What You Will Learn
- How adhesiolysis during a splenectomy is discussed in a coding question-and-answer format
- How NCCI bundling concepts can affect reporting of related surgical procedures
- What kind of documentation is generally relevant when additional operative work is documented
- When modifier 22 is discussed in relation to increased procedural services
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Surgical coding specialists
Codes Discussed
Modifiers Discussed
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