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Wiki Coding Colectomy, partial and 49905

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gmitchum

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My surgeons often have a procedure with Colectomy, partial and then do an Omental Flap, intra-abdominal. the codes are 44145 and 49905, which is an add on code. I have gotten denied for the 49905 stating that the primary code was not used. I have searched CMS, and found that they defer back to the insurance company for which I am billing. I have searched the sites for BCBS, UHC and several others without success in finding an answer as to what is the primary code. I even checked with the coding Hotline for General Surgery in my area and they said that there should be no reason why I can't file the two codes and get reimbursed. On the BCBS website I found a definition for 49905 is a column 1 code and is payable with appropriate modifier. My provider rep said to do a reconsideration claim with medical records and have the surgery reviewed by the committee. This may get my charges paid. Is there anyone who has had the problem of coding these two codes together and what was the result?
 
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