New options replace 49420 for tunneled catheter.
Choosing an intraperitoneal catheter insertion used to mean deciding between “permanent” and “temporary” — but CPT 2011 changes all that. Now you’ll need to know if the procedure is open, laparoscopic, or percutaneous in order to choose the proper code.
Follow our experts’ four tips to capture all the pay you deserve by properly maneuvering the following new and revised codes for intraperitoneal catheters:
- 49324 (revised) — Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter
- 49418 (new) — Insertion of tunneled intraperitoneal catheter (e.g., dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, contrast injection when performed, and radiological supervision and interpretation, percutaneous
- 49419 (revised) — Insertion of tunneled intraperitoneal catheter, with subcutaneous port (i.e., totally implantable)
- 49421 (revised) — Insertion of tunneled intraperitoneal catheter for dialysis, open
- 49422 (revised) — Removal of tunneled intraperitoneal catheter.
1. Drop ‘Permanent’ for ‘Tunneled’
CPT 2011 gives a facelift to coding for intraperitoneal catheters used for purposes such as chemotherapy or dialysis.
“The new coding disbands the distinction between ‘permanent’ and ‘temporary’ intraperitoneal catheters,” explains Marcella Bucknam, CPC, CCS-P, CPC-H, CCS, CPC-P, COBGC, CCC, manager of compliance education for the University of Washington Physicians Compliance Program in Seattle.
CPT 2011 deletes 49420 (Insertion of intraperitoneal cannula or catheter for drainage or dialysis; temporary) and revises 49421 from its 2010 definition (… permanent). The 2011 codes also drop the word “permanent” from 49324, 49419, and 49422. “These changes are helpful, because the distinction between ‘permanent’ and ‘temporary’ was not clear in practice,” says John F. Bishop, PA-C, CPC, MS, CWS, president of Tampa, Fla.-based Bishop and Associates.
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