How To Use CPT Code 49326

CPT 49326 describes a laparoscopic procedure known as omentopexy, which involves tucking away the omental loop that may be occluding the intraperitoneal catheter. 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 49326?

CPT 49326 is a laparoscopic procedure that involves omentopexy, which is the securing of the greater omentum to the abdominal wall. This procedure is performed subsequent to laparoscopic surgical exploration of the abdominal cavity for other purposes. The provider locates the omental loop, identifies any defects or areas of droop, and folds and lifts the omentum back into its normal size and location using suture material or staples. The procedure ensures that the omental loop does not obstruct the intraperitoneal catheter.

2. Official Description

The official description of CPT code 49326 is: ‘Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other primary procedure codes, such as 49324 and 49325.

3. Procedure

1. After the initial laparoscopic surgical exploration of the abdominal cavity, the provider enters the abdomen to place or revise an intraperitoneal catheter.
2. The provider locates the omental loop and identifies any defects or areas of droop.
3. Using suture material or staples, the provider folds and lifts the omentum back into its normal size and location.
4. Hemostasis is achieved to ensure there is no bleeding.
5. All instruments are removed, and the wound is closed in layers.

4. Qualifying circumstances

CPT 49326 is performed when the provider has already entered the abdomen to place or revise an intraperitoneal catheter. The omentopexy procedure is necessary when the omental loop is occluding the catheter, causing a blockage. The patient must be appropriately prepped and anesthetized for the initial procedure.

5. When to use CPT code 49326

CPT code 49326 should be used when performing the omentopexy procedure as an add-on to the primary laparoscopic surgical exploration of the abdominal cavity. It should not be reported as a standalone code and must be billed in conjunction with the primary procedure code.

6. Documentation requirements

To support a claim for CPT 49326, the provider must document the following information:

• Documentation of the primary procedure performed
• Description of the omentopexy procedure, including the location of the omental loop and any defects or areas of droop
• Details of the technique used to secure the omentum to the abdominal wall
• Evidence of achieving hemostasis
• Removal of instruments and closure of the wound in layers

7. Billing guidelines

When billing for CPT 49326, it is important to remember that this is an add-on code and should not be reported as a standalone code. It should be reported in addition to the primary procedure code, such as 49324 or 49325. Ensure that the documentation supports the performance of both the primary procedure and the omentopexy.

8. Historical information

CPT 49326 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes laparoscopic surgical exploration of the abdominal cavity, and during the procedure, the provider identifies an omental loop occluding the intraperitoneal catheter. The provider performs omentopexy to secure the omentum to the abdominal wall, ensuring proper catheter function.
2. During a laparoscopic procedure, the provider discovers an omental defect that needs to be addressed. The provider performs omentopexy to correct the defect and secure the omentum in its proper location.
3. After placing an intraperitoneal catheter, the provider notices that the omental loop is obstructing the catheter. The provider performs omentopexy to tuck away the omental loop and prevent further occlusion.
4. Following a laparoscopic surgical exploration, the provider identifies an area of droop in the omentum that may cause complications. The provider performs omentopexy to lift and secure the omentum, ensuring proper abdominal function.
5. During a laparoscopic procedure, the provider encounters an omental loop that is causing blockage. The provider performs omentopexy to secure the omentum and restore normal intraperitoneal flow.