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An extraperitoneal lymphocele refers to a collection of lymphatic fluid that accumulates in the retroperitoneal space, which is located behind the peritoneum, the membrane lining the abdominal cavity. This condition often arises as a result of surgical interventions or trauma that disrupts the normal flow of lymphatic fluid, leading to its accumulation. The procedure coded as CPT® 49062 involves the surgical drainage of this fluid collection by creating an opening in the abdominal wall. During the operation, the surgeon makes an incision to access the abdominal cavity and exposes the posterior aspect of the peritoneum. A careful incision is then made in the posterior peritoneum to create a small window, known as fenestration, which facilitates the drainage of lymphatic fluid from the retroperitoneal space into the peritoneal cavity. This fenestration is intentionally left open to ensure continuous drainage, and the abdominal incision is subsequently closed. This procedure is critical for alleviating symptoms associated with lymphocele and preventing complications that may arise from fluid accumulation.
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The procedure coded as CPT® 49062 is indicated for the management of extraperitoneal lymphoceles, which are fluid collections that occur in the retroperitoneal space. These lymphoceles typically arise due to surgical trauma, injury to lymphatic vessels, or other conditions that disrupt normal lymphatic drainage. The primary indications for performing this procedure include:
The procedure for CPT® 49062 involves several critical steps to ensure effective drainage of the lymphocele. The steps are as follows:
After the completion of the procedure, patients are typically monitored for any signs of complications, such as infection or excessive fluid accumulation. The open fenestration allows for ongoing drainage, which is crucial for preventing the re-accumulation of lymphatic fluid. Patients may be advised on post-operative care, including activity restrictions and signs to watch for that may indicate complications. Follow-up appointments are often scheduled to assess the healing process and ensure that the lymphatic drainage is functioning as intended.
| Short Descr | DRAIN TO PERITONEAL CAVITY | Medium Descr | DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN | Long Descr | Drainage of extraperitoneal lymphocele to peritoneal cavity, open | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 67 - Other therapeutic procedures, hemic and lymphatic system |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 1998-01-01 | Added | First appearance in code book in 1998. |
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