# 49406 or 49405 ???



## suela923@aol.com (Jan 26, 2015)

Which would you chose?  49406 or 49405?  Thanks! Sue

ULTRASOUND-GUIDED DRAINAGE CATHETER PLACEMENT

 History:

 Recurrent right perirenal fluid collection.

 Technique:

 Risks and benefits of the procedure were discussed with the patient and informed consent was obtained. The patient was placed prone and the right flank was evaluated with ultrasound with acquisition of permanent images. Based on these findings, the right flank was prepped and draped in the usual sterile fashion. Moderate sedation was begun and 2% lidocaine was administered for local anesthesia.

 Under direct ultrasound guidance with acquisition of permanent images, an 18-gauge trocar needle was advanced into the right perinephric space. A 0.035 inch Amplatz superstiff wire was coiled in the right perinephric space, over which a new 8-French locking loop drainage catheter was placed. Approximately 10 cc of clear brown fluid was aspirated and sent for creatinine analysis. The catheter was secured to the skin and placed to gravity drainage. The patient tolerated the procedure well and without immediate complication.

 Findings:

 Limited grayscale ultrasound images of the right flank reveal a large, simple appearing right perinephric fluid collection. There was successful placement of a new 8-French drainage catheter within this fluid collection.

Result Impression 

 Technically successful placement of a new 8-French drainage catheter within a simple appearing right perinephric fluid collection.


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## Cuteyr (Feb 3, 2015)

*49405*

For percutaneous, image-guided drainage of a perirenal/renal abscess, via catheter, Code 49405.


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