ED Coding and Reimbursement Alert

Reader Question:

49080* vs. 49420*

Question: Codes 49080* and 49420* seem to deal with the same procedure, and other than the amount of money reimbursed, I'm at a loss to know what indicators to use in charging the procedures. What is the difference between the two codes?

Gloria Peterson
Sheboygan Memorial Medical Center, Sheboygan, Wis.

Answer: There are several differences between the two codes. First, 49080* (peritoneocentesis, abdominal paracentesis, or peritoneal lavage [diagnostic or therapeutic]; initial) is usually performed to drain fluid for treatment or evaluation (i.e., reducing a buildup of fluid or analyzing it for the presence of blood) and then the drain is removed. It is performed with a small tube or needle.

Code 49420* (insertion of intraperitoneal cannula or catheter for drainage or dialysis; temporary) represents a procedure that can be used, among other things, for lavage, but is usually placed with the expectation that the service will be used for a longer period of time (over a period of hours, days or longer). A cannula, which is a larger-diameter tube, is placed through an incision and remains to perform functions such as dialysis or drainage that require a longer period of time to be effective, usually due to continued buildup of fluid.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

ED Coding and Reimbursement Alert

View All

Which Codify by AAPC tool is right for you?

Call 844-334-2816 to speak with a Codify by AAPC specialist now.