How To Use CPT Code 49014

CPT 49014 describes the re-exploration of a pelvic wound with the removal of preperitoneal pelvic packing, including repacking if necessary. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 49014?

CPT 49014 can be used to describe the procedure of reopening a pelvic wound and removing absorbent content pads from the preperitoneal space. If bleeding persists, the provider may also repack the area. This code is used when the re-exploration of the pelvic cavity is necessary to address ongoing issues or complications.

2. Official Description

The official description of CPT code 49014 is: ‘Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed.’

3. Procedure

1. The provider begins by reopening the previous suprapubic vertical midline skin incision.
2. They continue the incision through the subcutaneous tissue and fascia, making a midline incision.
3. Upon entering the preperitoneal space, the provider removes the laparotomy pads that were previously placed.
4. If bleeding persists, the provider may place up to six pads to achieve successful tamponade of the hemorrhage.
5. The fascia is closed with a running absorbable suture, and the skin is closed with staples.

4. Qualifying circumstances

CPT 49014 is performed when there is a need to re-explore a pelvic wound and remove preperitoneal pelvic packing. This procedure is typically done to address ongoing bleeding or complications in the pelvic cavity. It is important to ensure that the patient is stable enough to undergo the re-exploration procedure.

5. When to use CPT code 49014

CPT code 49014 should be used when the provider needs to reopen a pelvic wound and remove preperitoneal pelvic packing. This code is appropriate when the procedure includes repacking if necessary. It is important to note that this code should not be used for the initial placement of preperitoneal pelvic packing to control hemorrhage from high-energy pelvic trauma.

6. Documentation requirements

To support a claim for CPT 49014, the provider must document the following information:

• Patient’s condition necessitating the re-exploration of the pelvic wound
• Details of the procedure, including the reopening of the wound and removal of preperitoneal pelvic packing
• Any additional steps taken, such as repacking if necessary
• Date and duration of the procedure
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 49014, ensure that the procedure meets the criteria outlined in the official description. It is important to note that CPT code 49014 should not be reported with other codes unless specific circumstances warrant it. It is also essential to follow any additional guidelines provided by payers or regulatory bodies.

8. Historical information

CPT 49014 was added to the Current Procedural Terminology system on January 1, 2020. It was also added to the Inpatient Only (IPO) list for Medicare reimbursement purposes in the same year.

9. Examples

1. A patient undergoes re-exploration of a pelvic wound with the removal of preperitoneal pelvic packing due to ongoing bleeding.
2. A provider performs the procedure to address complications arising from a previous pelvic surgery.
3. A patient with a pelvic infection requires re-exploration of the wound and removal of preperitoneal pelvic packing.
4. A provider reopens a pelvic wound to assess and manage a postoperative hematoma.
5. A patient experiences persistent pain and swelling in the pelvic area, leading to the need for re-exploration and removal of preperitoneal pelvic packing.
6. A provider performs the procedure to address a pelvic abscess that has not responded to conservative treatment.
7. A patient with a history of pelvic trauma undergoes re-exploration of the wound to assess and manage ongoing bleeding.
8. A provider performs the procedure to remove infected preperitoneal pelvic packing and replace it with fresh packing.
9. A patient with a pelvic tumor requires re-exploration of the wound to address tumor recurrence and remove preperitoneal pelvic packing.
10. A provider performs the procedure to manage complications arising from a previous pelvic reconstructive surgery.