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Help with code '49418'

David Posted Fri 11th of March, 2011 16:37:55 PM

Does the surgeon have to use radiological guidance to use this code for a paracentesis of the abdomin?

SuperCoder Answered Sun 13th of March, 2011 21:25:26 PM

49080: For paracentesis, applicable codes are 49080/1 and the guidance used.
The physician inserts a needle or catheter into the abdominal cavity and withdraws and drains fluid for diagnostic or therapeutic purposes.

You can notice the significant difference between 49080 and 49418 from the below documentation for 49418. Check if your doc's documentation complies with documentation below:
49418: The physician makes a small "abdominal incision, opens the peritoneum" (the double-layered sac covering the internal organs and lining the abdominopelvic walls), and inserts the catheter into the cavity. The proximal end of the catheter is "tunneled subcutaneously away from the initial incision" and brought out through the skin. .... Alternately, the physician may percutaneously insert the catheter over a wire placed through a needle inserted into the peritoneal cavity. This code includes:imaging guidance, catheter placement, contrast injection when performed, and radiological supervision and interpretation

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