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Graham patch repair of duodenal ulcer

M

mgord

Guru
Messages
105
Location
Lewisburg, TN
I have always billed these procedures with codes 43840 and +49905 but recently received a denial from Cahaba stating the 43840 is not a valid primary procedure for this code. I submitted a redetermination to Cahaba and the decision was overturned and they are paying for the 49905. However in researching this denial, I came across several coders that do not agree with using 49905 and instead suggested using an unlisted code for the entire procedure or using 43840 with an unlisted code for the Graham patch. Thoughts? I have another one of these to code out today and I'm really leaning on coding 43840 with +49905.

Thanks in advance!!
 
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