How To Use CPT Code 49429

CPT 49429 describes the removal of a peritoneal-venous shunt, a procedure in which the provider makes one or two incisions to extract the 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 49429?

CPT 49429 is used to describe the removal of a peritoneal-venous shunt. During this procedure, the healthcare provider makes one or two incisions to carefully extract the catheter. The purpose of this code is to accurately document and bill for the removal of the shunt.

2. Official Description

The official description of CPT code 49429 is the “Removal of peritoneal-venous shunt.” This code specifically refers to the removal of a shunt that connects the peritoneum to a vein. It is important to note that CPT code 49429 should not be used for the ligation of a peritoneal venous shunt, which has its own distinct code (49428).

3. Procedure

1. When performing the removal of a peritoneal-venous shunt, the healthcare provider begins by making an abdominal incision over the site of the shunt.
2. Next, the provider isolates the peritoneal shunt from the surrounding scar tissue and carefully removes it from the abdominal cavity.
3. If necessary, the provider may need to dissect any scar tissue that has formed around the shunt due to its long-term placement.
4. If the venous part of the catheter can be easily accessed, the provider may be able to remove it through the abdominal incision.
5. However, if the venous catheter cannot be removed through the abdominal incision, the provider will make an additional incision over the insertion site and remove the catheter from the internal jugular vein.
6. Finally, the provider closes the wound site, which may involve the use of a patch and suturing it in layers to ensure proper healing.

4. Qualifying circumstances

CPT code 49429 is used when a peritoneal-venous shunt needs to be removed. This procedure is typically performed on patients who have experienced complications with their shunt or no longer require its use. It is important to note that this code should only be used for the removal of a peritoneal-venous shunt and not for other types of shunts or catheters.

5. When to use CPT code 49429

CPT code 49429 should be used when a healthcare provider performs the removal of a peritoneal-venous shunt. It is important to ensure that the procedure performed aligns with the specific details outlined in the code description. If the procedure involves the ligation of a peritoneal venous shunt instead, a different code (49428) should be used.

6. Documentation requirements

When documenting a claim for CPT code 49429, the healthcare provider must include the following information:

• Patient’s medical history and indication for shunt removal
• Details of the procedure, including the number of incisions made and any complications encountered
• Specific location of the shunt and the method used for its removal
• Any additional procedures performed during the same session
• Post-procedure care instructions and any follow-up appointments scheduled
• Provider’s signature and credentials

7. Billing guidelines

When billing for CPT code 49429, it is important to ensure that the procedure performed aligns with the specific details outlined in the code description. This code should not be reported with other codes unless additional procedures were performed during the same session. It is recommended to review the payer’s guidelines and policies to ensure accurate billing and reimbursement for this procedure.

8. Historical information

CPT code 49429 was added to the Current Procedural Terminology system on January 1, 1995. There have been no updates or changes to the code since its addition.

9. Examples

1. A surgeon performing the removal of a peritoneal-venous shunt for a patient who experienced complications with the shunt.
2. An interventional radiologist removing a peritoneal-venous shunt from a patient who no longer requires its use.
3. A neurosurgeon performing the removal of a peritoneal-venous shunt due to an infection at the insertion site.
4. A pediatric surgeon removing a peritoneal-venous shunt from a child who has outgrown the need for the shunt.
5. An oncologist removing a peritoneal-venous shunt from a cancer patient who has completed their treatment and no longer requires the shunt.
6. A vascular surgeon performing the removal of a peritoneal-venous shunt as part of a larger procedure to address vascular issues.
7. A general surgeon removing a peritoneal-venous shunt from a patient who experienced a blockage in the shunt.
8. An interventional radiologist removing a peritoneal-venous shunt from a patient who developed an allergic reaction to the materials used in the shunt.
9. A cardiothoracic surgeon removing a peritoneal-venous shunt from a patient who underwent a heart transplant and no longer requires the shunt for dialysis.
10. An urologist removing a peritoneal-venous shunt from a patient who has successfully undergone kidney transplantation.