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CPT®
49021

CPT® Code 49021
Deleted

Official Description

Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; percutaneous

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 49021 refers to the procedure for the drainage of a peritoneal abscess or localized peritonitis, specifically excluding appendiceal abscesses. A peritoneal abscess is defined as a localized collection of pus that occurs within the peritoneum, which is the membrane lining the abdominal cavity. This condition may also be referred to as an intraperitoneal abscess. Localized peritonitis, on the other hand, is characterized by inflammation of the peritoneal tissue in a specific, circumscribed area. The procedure can be performed using either an open technique, as described in CPT® Code 49020, or a percutaneous technique, as indicated by CPT® Code 49021. In the percutaneous approach, a needle is inserted into the suspected abscess cavity to aspirate fluid, which helps confirm the presence of pus. Following this, a drainage catheter is placed into the abscess cavity, often with the assistance of imaging guidance such as fluoroscopy, ultrasound, or CT. The abscess is then drained, and the cavity is thoroughly flushed with sterile saline or an antibiotic solution to ensure the removal of all debris, including pus, blood, and necrotic tissue. The catheter remains in place to facilitate continuous drainage of the abscess cavity, promoting healing and preventing further complications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 49021 is indicated for the following conditions:

  • Peritoneal Abscess A localized collection of pus within the peritoneum that requires drainage to alleviate symptoms and prevent complications.
  • Localized Peritonitis Inflammation of the peritoneal tissue in a specific area, necessitating intervention to manage infection and inflammation.

2. Procedure

The procedure for CPT® Code 49021 involves several critical steps to ensure effective drainage of the peritoneal abscess.

  • Step 1: Identification of the Abscess The first step involves the identification of the suspected peritoneal abscess. This is typically done through imaging studies, which may include ultrasound, CT scans, or fluoroscopy, to locate the abscess accurately.
  • Step 2: Needle Aspiration Once the abscess is located, a needle is carefully inserted into the abscess cavity. Fluid is aspirated from the cavity to confirm the presence of pus. This step is crucial as it not only verifies the diagnosis but also allows for the assessment of the fluid characteristics.
  • Step 3: Placement of Drainage Catheter After confirming the presence of pus, a drainage catheter is placed into the abscess cavity. This is done using imaging guidance to ensure accurate placement. The catheter facilitates the drainage of the abscess contents.
  • Step 4: Flushing the Abscess Cavity Following the placement of the catheter, the abscess cavity is flushed with sterile saline or an antibiotic solution. This flushing process is essential to clear the cavity of any remaining pus, blood, and necrotic tissue, promoting a clean environment for healing.
  • Step 5: Continuous Drainage The catheter is left in place to provide continuous drainage of the abscess cavity. This ongoing drainage is vital for preventing the re-accumulation of fluid and ensuring that the infection is adequately managed.

3. Post-Procedure

After the procedure, patients are typically monitored for any signs of complications, such as infection or bleeding. The catheter may remain in place for a specified duration, allowing for continuous drainage. Follow-up imaging may be required to assess the resolution of the abscess. Patients are advised on care for the catheter site and any signs of complications that should prompt immediate medical attention. The overall recovery process will depend on the patient's condition and the extent of the abscess.
Short Descr DRAIN ABDOMINAL ABSCESS
Medium Descr DRG PERITONEAL ABSCESS/LOCAL PERITONITIS PRQ
Long Descr Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; percutaneous
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple 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) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 99 - Other OR gastrointestinal therapeutic procedures
Date
Action
Notes
2014-01-01 Deleted Deleted
1997-01-01 Added Code added.
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