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The CPT® Code 49427 refers to an injection procedure specifically designed for the evaluation of a previously placed peritoneal-venous shunt. A peritoneal-venous shunt is a medical device utilized primarily in the management of ascites, which is characterized by the abnormal accumulation of fluid within the peritoneal cavity. This procedure involves the administration of a local anesthetic to the peritoneal cavity, ensuring patient comfort during the injection process. Following this, a contrast media or a radiotracer, such as technetium-99m sulfur colloid (TC99m-SC) or technetium-99m macroaggregated albumin (TC99m-MAA), is injected into the left lower quadrant of the abdomen. The choice of radiotracer is crucial for visualizing the flow and function of the shunt. In cases where a LeVeen shunt is present, the abdomen is gently massaged to facilitate the distribution of the radiotracer throughout the peritoneal cavity. Conversely, for patients with a Denver shunt, they are instructed to actively pump the system to ensure proper flow. After the injection procedure, it is essential to obtain radiographs, which are separately reportable, to assess the patency of the peritoneal-venous shunt, thereby confirming its functionality and effectiveness in managing the patient's condition.
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The injection procedure described by CPT® Code 49427 is indicated for the evaluation of previously placed peritoneal-venous shunts in patients experiencing ascites. The following conditions may warrant this procedure:
The procedure for CPT® Code 49427 involves several critical steps to ensure accurate evaluation of the peritoneal-venous shunt:
Post-procedure care following the injection procedure for CPT® Code 49427 typically includes monitoring the patient for any immediate adverse reactions to the injected materials. Patients may be advised to rest and avoid strenuous activities for a short period following the procedure. Additionally, the results of the radiographs should be reviewed promptly to assess the functionality of the shunt. Any findings that indicate complications or the need for further intervention should be communicated to the patient and documented in their medical record. Follow-up appointments may be scheduled to discuss the results and any necessary next steps in the management of the patient's condition.
| Short Descr | INJECTION ABDOMINAL SHUNT | Medium Descr | INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT | Long Descr | Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt | 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) | 0 - 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 97 - Other gastrointestinal diagnostic procedures |
| 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). | 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.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| 2011-01-01 | Changed | Medium description changed. Short description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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