How To Use CPT Code 49428

CPT 49428 describes the ligation of a peritoneal-venous shunt, which involves tying off the tube connecting a catheter emerging from the abdominal cavity with a catheter draining in the neck vein. 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 49428?

CPT 49428 is a code used to describe the ligation of a peritoneal-venous shunt. This procedure involves tying off the tube that connects a catheter emerging from the abdominal cavity with a catheter draining in the neck vein. The purpose of this procedure is to stop the flow of material through the shunt.

2. Official Description

The official description of CPT code 49428 is the ligation of a peritoneal-venous shunt. This procedure involves tying off the tube connecting a catheter emerging from the abdominal cavity with a catheter draining in the neck vein to stop the flow of material through the shunt.

3. Procedure

1. The provider begins by making a small incision above the subcutaneous tunnel enclosing the tube that passes between the abdominal cavity and the jugular vein.
2. Once the patient is appropriately prepped and anesthetized, the provider proceeds with the procedure.
3. The provider then uses suture material to tie off the tubing, ensuring that fluid no longer flows out of the abdomen.
4. After achieving hemostasis, the provider removes any instruments and closes the wound in layers.

4. Qualifying circumstances

CPT 49428 is performed on patients who have a peritoneal-venous shunt that needs to be ligated. This procedure is typically done to stop the flow of material through the shunt. The patient must meet the criteria for the procedure, and the provider must determine that ligation is necessary for the patient’s condition.

5. When to use CPT code 49428

CPT code 49428 should be used when a provider performs the ligation of a peritoneal-venous shunt. This code is appropriate when the provider ties off the tube connecting the catheter emerging from the abdominal cavity with the catheter draining in the neck vein to stop the flow of material through the shunt.

6. Documentation requirements

To support a claim for CPT 49428, the provider must document the following information:

• Patient’s diagnosis and the need for the ligation of the peritoneal-venous shunt
• Details of the procedure, including the incision site and the method used to tie off the tubing
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 49428, ensure that the procedure performed is the ligation of a peritoneal-venous shunt. Follow the appropriate coding guidelines and ensure accurate documentation to support the claim. It is important to review payer-specific guidelines and policies to ensure proper reimbursement.

8. Historical information

CPT 49428 was added to the Current Procedural Terminology system on January 1, 1995. In 2017, it was added under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs the ligation of a peritoneal-venous shunt to stop the flow of fluid in a patient with a malfunctioning shunt.
2. During a surgical procedure, a provider ties off the tube connecting the catheter emerging from the abdominal cavity with the catheter draining in the neck vein to prevent further complications in a patient with a peritoneal-venous shunt.
3. A patient with a peritoneal-venous shunt undergoes the ligation procedure to address a blockage in the shunt.
4. A provider performs the ligation of a peritoneal-venous shunt to manage the flow of material in a patient with a shunt-related infection.
5. During a surgical intervention, a provider ties off the tubing of a peritoneal-venous shunt to address a malfunction in the shunt system.
6. A patient with a peritoneal-venous shunt undergoes the ligation procedure to prevent further complications and improve their overall health.
7. A provider performs the ligation of a peritoneal-venous shunt to address a shunt-related complication in a patient.
8. During a surgical procedure, a provider ties off the tube connecting the catheter emerging from the abdominal cavity with the catheter draining in the neck vein to stop the flow of material in a patient with a peritoneal-venous shunt.
9. A patient with a peritoneal-venous shunt undergoes the ligation procedure to manage the flow of fluid and improve their quality of life.
10. A provider performs the ligation of a peritoneal-venous shunt to address a shunt malfunction and prevent further complications in a patient.