Reader Questions:
Distinguish Lap vs. Open for Omental Flap Coding
Published on Fri Nov 27, 2009
Question: How should I report a ureteral lysis and omental wrapping of the ureter for the treatment of retroperitoneal fibrosis? Should I use 49329? Alaska Subscriber Answer: The answer depends on the approach your urologist used. If he performed these procedures via an open abdominal approach, report 50715 (Ureterolysis with or without repositioning of ureter for retroperitoneal fibrosis) and +49905 (Omental flap, intra-abdominal [List separately in addition to code for primary procedure]). Keep in mind that this latter code is an add-on code and you can report +49905 only in addition to a primary procedure. In this scenario, 50715 is the primary CPT code, and +49905 is the add-on code. Alternative: If your urologist performed the entire procedure laparoscopically, you should instead use the unlisted laparoscopic code 50949 (Unlisted laparoscopy procedure, ureter) for the ureterolysis and 49329 (Unlisted laparoscopy procedure, abdomen, peritoneum and omentum) for the omental wrap. Since CPT [...]
