CPT Code 49904
CPT code 49904 is for an omental flap procedure performed outside the abdomen, used in surgical reconstruction.
Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.
What is CPT Code 49904
CPT code 49904 is used to describe a surgical procedure involving the creation of an omental flap that is performed outside of the abdominal cavity. This procedure typically involves mobilizing a portion of the omentum, which is a fold of peritoneum extending from the stomach, to provide coverage or support to a defect or injury in another area of the body. It is often utilized in reconstructive surgery to enhance healing or improve the function of the affected area.
Does CPT 49904 Need a Modifier?
#ERROR!
CPT Code 49904 Medicare Reimbursement
The CPT code 49904 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) to determine the specific reimbursement rate. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment amounts.
Additionally, reimbursement for CPT code 49904 may vary based on the policies of the Medicare Administrative Contractor (MAC) in your region. Each MAC has the authority to interpret national Medicare policies and make local coverage determinations, which can influence whether and how a particular service is reimbursed.
Therefore, it is advisable to consult both the MPFS and your regional MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 49904.
Are You Being Underpaid for 49904 CPT Code?
Discover how MD Clarity's RevFind software can read your contracts and detect underpayments down to the CPT code level and by individual payer. With RevFind, you can ensure you're receiving accurate payments for services like CPT code 49904. Schedule a demo today to see how RevFind can help you identify and recover lost revenue.
Get paid in full by bringing clarity to your revenue cycle
Related CPT Codes
CPT Code 92120
CPT code 92120 is a medical billing code for tonography and eye evaluation procedures.
CPT Code 92265
CPT code 92265 is used for billing an eye muscle evaluation by a healthcare provider.
CPT Code 92311
CPT code 92311 is used for billing a contact lens fitting by healthcare providers.
CPT Code 92312
CPT code 92312 is used to bill for the professional service of fitting contact lenses.
CPT Code 92353
CPT code 92353 is for fitting a multifocal lens spectacle for patients with aphakia.
CPT Code 92354
CPT code 92354 is a medical billing code used for fitting single vision spectacles.
CPT Code 92355
CPT code 92355 is used for billing the fitting of spectacles with compound lenses.
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox