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Ob-Gyn Coding Alert

Reader Question:
Watch for Adhesiolysis Bundles

Question: How should I bill for a laparotomy, Moschowitz procedure, lysis of adhesions and enterolysis?

Missouri Subscriber Answer: The laparotomy is the ob-gyn's approach, and you should not code that separately. The Moschowitz procedure is an enterocele repair via an abdominal approach, which you would report with 57270 (Repair of enterocele, abdominal approach [separate procedure]).
As for the lysis of adhesions, you could bill 58740 (Lysis of adhesions [salpingolysis, ovariolysis]). And you would use 44005 (Enterolysis [freeing of intestinal adhesion] [separate procedure]) for the enterolysis.
But most payers bundle adhesiolysis and enterolysis when the physician performs them with other procedures. So you shouldn't report them unless the ob-gyn's documentation shows significant work in doing the lysis. In that case, you could report 57270-22 (Unusual procedural services).

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