How To Use CPT Code 49423

CPT 49423 describes the procedure of exchanging a previously placed abscess or cyst drainage catheter under radiological guidance. 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 49423?

CPT 49423 can be used to describe the exchange of a drainage catheter that has already been placed to drain an abdominal cyst or abscess. This procedure involves removing the existing catheter and replacing it with a new one.

2. Official Description

The official description of CPT code 49423 is: ‘Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure).’ This code does not include radiological supervision and interpretation, which should be reported separately using code 75984.

3. Procedure

1. The provider begins by removing any sutures holding the existing catheter in place.
2. A guidewire is then inserted through the catheter, and the provider removes the catheter over the guidewire.
3. The provider inspects the catheter to ensure it is intact and no portion remains inside the body.
4. The site is cleaned with antibiotic swabs, and the abdomen is washed out with antibiotics.
5. Radiological guidance is used to identify the correct location for the new catheter.
6. The provider guides the placement of the new catheter system over the guidewire.
7. The provider verifies that the new catheter is draining properly before suturing it to the skin.

4. Qualifying circumstances

CPT 49423 is performed when there is a need to exchange a previously placed drainage catheter for an abdominal cyst or abscess. The procedure must be performed under radiological guidance. It is important to note that this code does not include radiological supervision and interpretation, which should be reported separately using code 75984.

5. When to use CPT code 49423

CPT code 49423 should be used when a provider is performing the exchange of a previously placed abscess or cyst drainage catheter under radiological guidance. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 49423, the provider must document the following information:

• Reason for the exchange of the drainage catheter
• Details of the procedure, including the use of radiological guidance
• Confirmation of proper placement and function of the new catheter
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 49423, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The code does not include radiological supervision and interpretation, which should be reported separately using code 75984. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 49423 was added to the Current Procedural Terminology system on January 1, 1998. There have been no updates to the code since its addition.

9. Examples

1. A provider exchanges a drainage catheter for an abdominal abscess under radiological guidance.
2. A patient with a cyst undergoes the exchange of a drainage catheter under radiological guidance.
3. A provider removes an existing catheter and replaces it with a new one for a patient with an abdominal abscess.
4. A drainage catheter is exchanged for a patient with a cyst using radiological guidance.
5. A provider performs the exchange of a drainage catheter for an abdominal abscess, ensuring proper placement and function.
6. An existing catheter is removed and replaced with a new one for a patient with a cyst, guided by radiological imaging.
7. A provider exchanges a drainage catheter for an abdominal abscess, documenting the procedure and confirming proper placement.
8. A patient with a cyst undergoes the exchange of a drainage catheter, with radiological guidance to ensure accurate placement.
9. A provider removes an existing catheter and replaces it with a new one for a patient with an abdominal abscess, following radiological guidance.
10. A drainage catheter is exchanged for a patient with a cyst, with the provider verifying proper drainage before suturing the catheter to the skin.