Asked • 04/06/21

How do you know what procedure to code for?

When it comes to Medical Coding you have 1 major/minor procedure but there are little procedures performed to be able to perform the big procedure. For example, lysis of adhesions. If the provider has to remove these to be able to perform his intended procedure this is included in the major/minor procedure and you would not separately code for the lysis of adhesions.

Audrey P.

Great question...if lysis of adhesions are needed in order to perform a more extensive procedure. You cannot code lysis of adhesions as it is seen as integral to the major procedure. Per CMS coding guidelines: "Services integral to HCPCS/CPT code defined procedures are included in those procedures based upon the standards of medical/surgical practice. It is inappropriate to separately report services that are integral to another procedure with that procedure." For any medical coding tutoring needs. Please contact Audrey P! Happy to help!
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04/23/21

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Christine F. answered • 08/20/21

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Hi,

Yes lysis of adhesions is considered to be bundled into major procedures. However in some cases if the provider documents the time spent performing the lysis of adhesions or makes a medical attestation stating the extent it would also be acceptable to use a modifier 22. If it does meet the requirement they provider can bill for increased procedure service :)

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