# chest tube exchange



## Shirleybala (Mar 18, 2009)

How to code chest tube exchange ,can i code 49423 please confirm


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## MLS2 (Mar 18, 2009)

I would think that a chest tube placed for drainage would fall under cpt 49423

Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)


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## Shirleybala (Mar 19, 2009)

Thankyou


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## kmschwarz (Jan 6, 2014)

MLS2 said:


> I would think that a chest tube placed for drainage would fall under cpt 49423
> 
> Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)



This question was asked again recently....Can you please provide the source where you got that answer from? My concern is that the pleural drainage catheter placement code is 32557, which falls under the Surgery/Respiratory, and 49423 falls under Surgery/Digestive. We are thinking to either bill 32557-52 or the unlisted 32999.


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## kbazarte@yahoo.com (Jan 25, 2014)

Kristen I posed the same question in a different forum and the answer I got back was also 32557-52 or 32999


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## margaret fahy (Jan 27, 2014)

*49423-chest tube xchange*

Hi,
It would be 49423/75984.
Margie


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## kmschwarz (Jan 27, 2014)

margaret fahy said:


> Hi,
> It would be 49423/75984.
> Margie



I was just curious where you got that from - ACR, AAPC, AMA, etc.  We recently attended the CSI CROWN Seminar Series, and I was looking through the IR book from them, and found the following: "...If the chest tube is replaced during the same encounter when it was inserted, the replacement is included in the insertion code.  However, if it is replaced at a later encounter, this procedure is separately reportable.  Report the tube replacement with code 32557-52. Modifier 52 is used since the tube is being replaced through the same tract.  For replacement of a drainage tube for empyema (pleural abscess), use the abscess drainage catheter replacement code 49423 rather than 32557-52. (See _Clinical Examples in Radiology_, Summer 2013)"


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## margaret fahy (Jan 27, 2014)

*Chest tube xchange*

Kristen,
I have asked this question of CSI, and I was told that, yes, 49423...as it states in the book...exchange of any drainage catheter.
I feel comfortable with this code.
What do you think?
Margie


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