# 49021 vs 49083???!!!



## icoutin (Mar 29, 2012)

May be a no-brainer, but I'm all out of brain this morning

What is the difference between the two codes? (other than you can code S&I w/ 49021 and it is included in 49083).

Have a case where a pigtail catheter was placed via CT guidance to drain what the physician calls "fluid collection/abscess/air" in the abdominoperitoneal cavity.

Is this 49021 or 49083?  I used to think if you are draining an abscess it is 49021 and when you remove just fluid such as ascites, it is 49083 but the code description does not seem clear (49083 is a new code).  Also i used to think that the difference may be needle use vs catheter but the description for 49083 discusses the use of either.

Please, anyone up to the challenge???????


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## jmcpolin (Mar 29, 2012)

49083 no drain is left in place 49021 a drain is placed and removed at a later date.


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## icoutin (Mar 29, 2012)

Thank you for your response.  I misunderstood the clinical example in the 2012 CPT changes book, where it stated the "ascites catheter is advanced into the ascites and secured in place temporarily " to mean the cath stayed rather than that it stayed for the duration of the procedure and then removed.

Thank you again for such a prompt response!!!


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## donnajrichmond (Apr 1, 2012)

I disagree.  The difference is that 49021 is specific to abscess drainage, 49083 is not specific though it is usually seen for aspiration of paracentesis.  
Whether or not the catheter is left in does not matter.


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