Repair of Pyloric Channel Ulcer with Graham Patch

Question:

Hello, we are reporting repair of pyloric channel ulcer with 43840 and the omental flap with 49905, we keep getting feedback from an external auditor that 49905 is not separately reportable. Could you please clarify how this procedure should be reported and the reasoning?

Answer:

Code +49905 is not reported separately when used to secure a suture line in an ulcer repair as you described, or for securing an anastomosis in colon resection as another example.

CPT code +49905, omental flap, intraabdominal, is intended for an omental flap to reconstruct a defect, for example after lesion resection, to fill an anatomic defect resulting from that resection.

*This response is based on the best information available as of 02/05/26.