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The CPT® Code 49426 refers to the procedure known as the revision of a peritoneal-venous shunt. This medical intervention is performed by a physician to address issues related to an existing peritoneal-venous shunt, which is a device used primarily for the management of ascites, a condition characterized by the accumulation of fluid in the peritoneal cavity. The peritoneal-venous shunt facilitates the drainage of excess fluid from the peritoneal cavity into the venous system, thereby alleviating the symptoms associated with ascites. The procedure involves either repositioning or replacing components of the shunt, depending on the specific malfunction. This may include adjustments to the peritoneal shunt itself, the valve that regulates fluid flow, or the venous catheter that connects to the bloodstream. The revision process is critical to ensure the continued effectiveness of the shunt in managing fluid levels and preventing complications associated with ascites.
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The revision of a peritoneal-venous shunt, coded as CPT® 49426, is indicated in the following scenarios:
The procedure for revising a peritoneal-venous shunt involves several critical steps, which are detailed as follows:
Following the revision of a peritoneal-venous shunt, patients are typically monitored for any immediate complications, such as bleeding or infection at the incision site. Instructions for post-procedure care will be provided, which may include guidelines on activity restrictions, signs of complications to watch for, and follow-up appointments to assess the functionality of the revised shunt. Patients may also be advised on dietary modifications or fluid management strategies to support recovery and prevent recurrence of ascites.
| Short Descr | REVISE ABDOMEN-VENOUS SHUNT | Medium Descr | REVIS PERITONEAL-VENOUS SHUNT | Long Descr | Revision of peritoneal-venous shunt | 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) | 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 99 - Other OR gastrointestinal therapeutic procedures |
| 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.) | 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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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