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Lee Posted Mon 22nd of October, 2012 14:49:48 PM

I need a cpt code for a fistulagram performed for the purposes to see if there is communication between the presacral space and the rectum. Patient had a presacral abscess that was previously drained, but a month later there was still to much fluid leaking.

SuperCoder Answered Mon 22nd of October, 2012 23:20:14 PM

The proper code for this service is 49465 (Contrast injection[s] for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastrojejunostomy, or cecostomy [or other colonic] tube, from a percutaneous approach including image documentation and report).

This code does not have professional and technical components under the Medicare Physician Fee Schedule, so you should not append modifier 26 (Professional component) to report the physician's service.

You also should not add 76080 (Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation) because 49465 includes "image documentation and report."

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