How To Use CPT Code 49323

CPT 49323 describes a laparoscopic surgical procedure that involves the drainage of a lymphocele to the peritoneal cavity. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 49323?

CPT 49323 is a code used to describe a laparoscopic surgical procedure that involves the drainage of a lymphocele to the peritoneal cavity. This procedure is performed using a laparoscope, which is a tubular instrument with a light source and camera that allows the provider to examine the inside of the abdomen. The purpose of this procedure is to eliminate pain and reduce the chance of infection by draining the trapped fluid in the lymphocele.

2. Official Description

The official description of CPT code 49323 is: ‘Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity.’ It is important to note that for open drainage of a lymphocele to the peritoneal cavity, a different code, 49062, should be used.

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. A small incision is made at the umbilicus, which is used as an entry point for the laparoscope.
3. The abdomen is inflated with carbon dioxide to improve visualization of the site of interest.
4. Additional small incisions are made to insert the laparoscope and other instruments needed for the procedure.
5. The provider uses suction to evacuate any free fluid in the abdomen.
6. The organs and structures in the abdomen are examined for evidence of disease.
7. If a lymphocele is identified, the provider opens it to allow the trapped fluid to drain into the peritoneal cavity.
8. A culture of the lymphocele’s contents may be taken for laboratory analysis.
9. The area is irrigated with an antibiotic solution to prevent infection.
10. The provider checks for bleeding, removes the instruments, and closes the incisions.

4. Qualifying circumstances

CPT 49323 is used for patients who have a lymphocele, which is a collection of fluid from the lymph system that becomes trapped in an area of tissue damage due to injury or surgery. This procedure is typically performed following abdominal trauma or extensive abdominal surgery. The purpose of the procedure is to drain the lymphocele into the peritoneal cavity, relieving pain and reducing the risk of infection.

5. When to use CPT code 49323

CPT code 49323 should be used when a laparoscopic surgical procedure is performed to drain a lymphocele to the peritoneal cavity. It is important to note that if the drainage is performed through an open procedure, a different code, 49062, should be used instead.

6. Documentation requirements

To support a claim for CPT 49323, the provider must document the following information:

• Patient’s diagnosis and the presence of a lymphocele
• Details of the laparoscopic procedure, including the specific steps performed
• Date of the procedure
• Start and end time of the procedure
• Any additional findings or procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 49323, ensure that the procedure is performed using a laparoscopic approach and involves the drainage of a lymphocele to the peritoneal cavity. It is important to use the correct code for open drainage of a lymphocele (49062) if that procedure is performed instead. CPT code 49323 should not be reported with other codes for the same procedure. It is important to follow the specific guidelines provided by the payer when submitting claims for this procedure.

8. Historical information

CPT 49323 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a laparoscopic procedure for the drainage of a lymphocele following abdominal trauma.
2. A provider performs a laparoscopic procedure to drain a lymphocele that developed after extensive abdominal surgery.
3. A patient with a lymphocele undergoes a laparoscopic procedure to relieve pain and reduce the risk of infection.
4. A provider uses a laparoscope to drain a lymphocele into the peritoneal cavity, eliminating pain and promoting healing.
5. A laparoscopic procedure is performed to drain a lymphocele, improving the patient’s overall condition and quality of life.
6. A provider successfully drains a lymphocele using a laparoscopic approach, providing relief to the patient.
7. A patient with a lymphocele undergoes a laparoscopic procedure, resulting in the resolution of symptoms and improved well-being.
8. A provider performs a laparoscopic drainage procedure for a lymphocele, preventing the development of complications.
9. A laparoscopic procedure is performed to drain a lymphocele, allowing the patient to recover and resume normal activities.
10. A patient undergoes a laparoscopic procedure for the drainage of a lymphocele, experiencing significant improvement in their condition.