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The procedure described by CPT® Code 49322 refers to a laparoscopic surgical technique that involves the aspiration of fluid from a cavity or cyst, such as an ovarian cyst. This minimally invasive approach begins with the placement of a port near the umbilicus, through which a pneumoperitoneum is established by insufflating air into the abdominal cavity. This process allows for the expansion of the abdominal space, providing the surgeon with a clear view of the internal structures using a laparoscope equipped with a video camera. The laparoscope enables thorough inspection of the abdominal cavity, peritoneum, and omentum for any signs of malignancy, disease, or injury. Once the target cavity or cyst is identified, an aspiration needle is introduced through the laparoscope to puncture the cyst or cavity, allowing for the extraction of fluid. This procedure can involve the aspiration of fluid from multiple cavities or cysts if necessary. After the aspiration is completed, the surgeon inspects the puncture sites for any bleeding, which can be controlled using laser or electrocautery techniques. Finally, the instruments are carefully withdrawn, and pressure is applied to the abdomen to expel any residual air from the peritoneal cavity before closing the portal incisions. This technique is valued for its reduced recovery time and minimal scarring compared to traditional open surgical methods.
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The procedure described by CPT® Code 49322 is indicated for the aspiration of fluid from cysts or cavities within the abdominal cavity. The following conditions may warrant this procedure:
The laparoscopic aspiration procedure begins with the establishment of a periumbilical port, which serves as the entry point for the laparoscope. The surgeon insufflates the abdominal cavity with air to create a pneumoperitoneum, allowing for better visualization of the internal structures. Once the abdominal cavity is adequately inflated, the laparoscope is inserted through the port. This instrument, equipped with a video camera, provides a clear view of the entire abdominal cavity, including the peritoneum and omentum, enabling the surgeon to inspect for any signs of malignancy, disease, or injury.
After a thorough inspection, the surgeon locates the target cavity or cyst. An aspiration needle is then carefully inserted through the laparoscope to puncture the cyst or cavity. This step is crucial as it allows for the extraction of fluid, which can be performed on one or multiple cavities or cysts as needed. The fluid is aspirated, and the volume and characteristics of the fluid may be noted for further analysis.
Upon completion of the aspiration, the surgeon inspects the puncture sites for any signs of bleeding. If bleeding is observed, it is controlled using laser or electrocautery techniques to ensure patient safety. Following this, the instruments are withdrawn from the abdominal cavity. To finalize the procedure, pressure is applied to the abdomen to express any remaining air from the peritoneum. Finally, the portal incisions are closed, completing the laparoscopic aspiration procedure.
After the laparoscopic aspiration procedure, patients are typically monitored for any immediate complications, such as bleeding or infection. Recovery may vary depending on the individual and the extent of the procedure, but patients can generally expect a shorter recovery time compared to traditional open surgery. Post-procedure care may include pain management and instructions for activity restrictions to promote healing. Follow-up appointments may be scheduled to assess the patient's recovery and to discuss the results of any fluid analysis performed on the aspirated material.
| Short Descr | LAPAROSCOPY ASPIRATION | Medium Descr | LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE | Long Descr | Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple) | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 87 - Laparoscopy |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Changed | Code description changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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