Wiki Falciform Ligament Flap - Surgeon performed

[gost]

Surgeon performed:

Whipple w/partial gastrectomy
Cholecystectomy
Pancreas bx
Retroperitoneal lymphadenectomy
and created a falciform ligament pedicle flap to cover the gastroduodenal artery stump. Is the flap included in the other procedures? If not, any idea how to code it?

 

[monbel]

The cholecystectomy is included in the whipple. I have billed for the falciform ligament under 49999 (along with med necessity letter & operative report) and have received payment from all carriers but Anthem. Anthem is the only carrier that states that it is included in the whipple but they can't seem to indicate how it's included. All other carriers have paid after I have appealed them. Hope that helps you!

 

[gost]

Thanks.