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General Surgery Coding Alert

Enterolysis Coding:
44005 and 44180: Know When to Punt to Modifier 22

Bundling rules restrict separate lysis-of-adhesions coding. When your surgeon cuts through adhesions during abdominal surgery, is there any way for you to ethically capture pay for the extra work? The answer is a qualified "yes," according to our experts. Read on to learn the circumstances that warrant additional billing, and the coding methods to capture adhesiolysis pay. Recognize Conditions for Separate Enterolysis Although CPT® provides the following two codes for adhesiolysis, "separate procedure" rules and Correct Coding Initiative (CCI) edits bundle the service with most abdominal surgeries: 44005 -- Enterolysis (freeing of intestinal adhesion) (separate procedure) 44180 -- Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure). Those restrictions mean that you should separately report freeing of intestinal adhesions only under three circumstances: 1. Enterolysis is the only procedure your surgeon performs during the operative session 2. The adhesions are in a different anatomic site or surgical session from the primary procedure [...]