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The procedure described by CPT® Code 49429 involves the removal of a peritoneal-venous shunt, which is a medical device used to manage ascites, a condition characterized by the accumulation of fluid in the peritoneal cavity. This shunt facilitates the drainage of excess fluid from the abdominal cavity into the venous system, thereby alleviating pressure and discomfort associated with ascites. During the removal process, the physician makes incisions in both the upper chest and the abdomen, specifically at the sites where the shunt tubing enters the jugular vein and the peritoneal cavity, respectively. The procedure requires careful dissection of the shunt tubing from the surrounding tissues to ensure complete removal without causing damage to adjacent structures. Following the removal, the incisions are sutured closed to promote proper healing. This procedure is typically indicated when the shunt is no longer needed or if complications arise that necessitate its removal.
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The removal of a peritoneal-venous shunt, as indicated by CPT® Code 49429, is performed under specific circumstances related to the management of ascites. The following conditions may warrant this procedure:
The procedure for the removal of a peritoneal-venous shunt involves several critical steps to ensure safe and effective removal. The following outlines the procedural steps:
After the removal of the peritoneal-venous shunt, patients are typically monitored for any immediate complications, such as bleeding or infection at the incision sites. Post-procedure care may include pain management and instructions for wound care to ensure proper healing. Patients may also be advised on signs of complications to watch for, such as increased redness, swelling, or discharge from the incisions. Follow-up appointments may be scheduled to assess recovery and address any ongoing issues related to ascites or the underlying condition.
| Short Descr | REMOVAL OF SHUNT | Medium Descr | RMVL PERITONEAL-VENOUS SHUNT | Long Descr | Removal of peritoneal-venous shunt | Status Code | Active Code | Global Days | 010 - 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 | T-Packaged Codes | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; 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 |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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.) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 1995-01-01 | Added | First appearance in code book in 1995. |
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