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Wiki Help please! dialysis access coding question

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pat307ep

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When a Tenckhoff catheter is placed using CPT code 49421, can I code for an omentectomy using CPT code 49255? The operative report clearly states the need for the omentectomy as the patient is obese and the omentum would endanger the function of the PD catheter if not removed. However, when I have coded for the omentectomy Medicare denies that portion of my claim. Has anyone experinced this situation? I actually have a lot of cases that are similar to this one. Should I not be coding for the omentectomy? Thanks, any assistance is appreciated!
 
No, the omentectomy is a designated "(separate procedure)", and isn't billable with the Tenkhoff placement. They pretty much view it the way they view LOA with any other open abdominal procedure.
 
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