How To Use CPT Code 49419

CPT 49419 describes the insertion of a tunneled intraperitoneal catheter with a subcutaneous port. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 49419?

CPT 49419 is used to describe the surgical procedure of inserting a catheter within the abdominal cavity and creating a subcutaneous pocket in the fascia of the rectus muscle to hold a pump reservoir. This procedure is performed to establish a delivery system for administering chemotherapy drugs to patients with abdominal cancer or to administer other therapeutic agents such as insulin or morphine.

2. Official Description

The official description of CPT code 49419 is the insertion of a tunneled intraperitoneal catheter with a subcutaneous port (totally implantable). This procedure involves creating a pocket in the fascia of the rectus muscle to hold the reservoir and tunneling the catheter through the subcutaneous tissue to the peritoneum. The catheter is then placed into the target location within the peritoneal cavity.

3. Procedure

1. The provider begins by making an incision in the lower or middle abdomen and creating a pocket in the fascia of the rectus muscle.
2. A second small incision is made a few inches away, and the provider carefully places the catheter into the appropriate area of the peritoneum.
3. Using X-ray guidance, the provider tunnels the catheter through the subcutaneous tissue to the peritoneum and places it into the target location.
4. An X-ray may be performed after the procedure to ensure proper placement of the port and catheter.
5. The provider closes the incisions and ensures hemostasis.

4. Qualifying circumstances

CPT 49419 is performed on patients who require the administration of chemotherapy drugs for abdominal cancer or other therapeutic agents. The procedure is typically performed by a provider who is experienced in this specific technique. The patient must have a medical need for the intraperitoneal catheter and meet the criteria for receiving the specific treatment.

5. When to use CPT code 49419

CPT code 49419 should be used when a provider performs the insertion of a tunneled intraperitoneal catheter with a subcutaneous port. This code is appropriate for cases where the patient requires the administration of chemotherapy drugs or other therapeutic agents through the intraperitoneal route. It should not be used for other types of catheter insertions or procedures.

6. Documentation requirements

To support a claim for CPT 49419, the provider must document the following information:

• Patient’s diagnosis and medical need for the intraperitoneal catheter
• Description of the procedure performed, including the creation of the pocket and tunneling of the catheter
• Date of the procedure
• Any imaging guidance used during the procedure
• Confirmation of proper placement of the port and catheter
• Details of any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 49419, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the medical necessity and details of the procedure to support the claim. CPT code 49419 should not be reported with other codes unless additional procedures or services were performed during the same session.

8. Historical information

CPT 49419 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider inserts a tunneled intraperitoneal catheter with a subcutaneous port for a patient undergoing chemotherapy for abdominal cancer.
2. A patient with ascites requires the insertion of a tunneled intraperitoneal catheter for the management of fluid buildup in the abdominal cavity.
3. A provider performs the insertion of a tunneled intraperitoneal catheter with a subcutaneous port to administer insulin to a patient with diabetes.
4. A patient with chronic pain requires the insertion of a tunneled intraperitoneal catheter for the administration of morphine.
5. A provider inserts a tunneled intraperitoneal catheter with a subcutaneous port to deliver therapeutic agents for the treatment of a specific medical condition.
6. Provide four more examples of cases where CPT code 49419 should be billed. Only explain the examples and make them all original. Do not include ‘CPT 49419” or ‘CPT code 49419” in the text of an example.