How To Use CPT Code 49906

CPT 49906 describes the use of a free omental flap with microvascular anastomosis during reconstructive surgery. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 49906?

CPT 49906 can be used to describe the use of a free omental flap with microvascular anastomosis during reconstructive surgery. This code is used when a provider harvests a flap of omentum, detaching it from the vessels in its abdominal location, and uses it to fill defects in other locations in the body, such as the breast, head and neck, or extremities. The provider utilizes an operative microscope and microsurgical techniques to reconnect the vessels at the new location.

2. Official Description

The official description of CPT code 49906 is: ‘Free omental flap with microvascular anastomosis.’

3. Procedure

1. During reconstructive surgery, the provider makes a laparotomy incision to open up the abdomen.
2. The provider harvests a flap of omentum, detaching it from the vessels in its abdominal location.
3. The provider positions the free omental flap graft in its new location and uses an operative microscope and microsurgical techniques to connect the arteries and veins to the flap.
4. The provider secures the omental flap in place and closes the abdominal wound in layers.
5. The separate reconstructive procedure continues to its completion.

4. Qualifying circumstances

CPT 49906 is used when a provider performs a free omental flap with microvascular anastomosis during reconstructive surgery. This procedure is typically performed when there are defects in other locations in the body, such as the breast, head and neck, or extremities, that need to be filled. The provider must utilize an operative microscope and microsurgical techniques to connect the arteries and veins to the flap.

5. When to use CPT code 49906

CPT code 49906 should be used when a provider performs a free omental flap with microvascular anastomosis during reconstructive surgery. This code should not be used for any other procedures or circumstances.

6. Documentation requirements

To support a claim for CPT 49906, the provider must document the following information:

• Description of the defect being filled with the omental flap
• Details of the microvascular anastomosis performed
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 49906, ensure that the procedure meets the qualifying circumstances described above. There are no specific billing guidelines or modifiers associated with this code.

8. Historical information

CPT 49906 was added to the Current Procedural Terminology system on January 1, 1997. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider performs a free omental flap with microvascular anastomosis to fill a defect in the breast during reconstructive surgery.
2. A provider utilizes a free omental flap with microvascular anastomosis to fill a defect in the head and neck region during reconstructive surgery.
3. A provider performs a free omental flap with microvascular anastomosis to fill a defect in the extremities during reconstructive surgery.
4. A provider utilizes a free omental flap with microvascular anastomosis to fill a defect in the chest cavity during reconstructive surgery.
5. A provider performs a free omental flap with microvascular anastomosis to fill a defect in the abdominal region during reconstructive surgery.
6. A provider utilizes a free omental flap with microvascular anastomosis to fill a defect in the pelvic region during reconstructive surgery.
7. A provider performs a free omental flap with microvascular anastomosis to fill a defect in the back during reconstructive surgery.
8. A provider utilizes a free omental flap with microvascular anastomosis to fill a defect in the buttocks during reconstructive surgery.
9. A provider performs a free omental flap with microvascular anastomosis to fill a defect in the thigh during reconstructive surgery.
10. A provider utilizes a free omental flap with microvascular anastomosis to fill a defect in the lower leg during reconstructive surgery.