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The CPT® Code 49435 refers to the procedure involving the insertion of a subcutaneous extension to an intraperitoneal cannula or catheter, which includes a remote chest exit site. This procedure is classified as an add-on, meaning it is performed in conjunction with a primary procedure and should be reported separately. The process begins with the physician inserting an extension that connects to an existing abdominal cannula or catheter, which is already placed within the peritoneal cavity. The extension is then threaded subcutaneously, allowing it to exit through a designated remote site located on the chest. This technique is typically utilized to facilitate easier access to the intraperitoneal space for therapeutic or diagnostic purposes, while minimizing the risk of infection and other complications associated with direct access to the abdominal cavity.
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The procedure described by CPT® Code 49435 is indicated for patients who require extended access to the intraperitoneal space for various therapeutic or diagnostic interventions. This may include situations where ongoing treatment, such as chemotherapy or dialysis, is necessary, or when frequent sampling of peritoneal fluid is required. The use of a subcutaneous extension allows for a more convenient and less invasive method of accessing the intraperitoneal catheter, reducing the need for repeated abdominal punctures.
The procedure for CPT® Code 49435 involves several key steps that ensure the successful insertion of the subcutaneous extension to the intraperitoneal cannula or catheter.
After the procedure, the patient is monitored for any immediate complications, such as bleeding or infection at the insertion and exit sites. Instructions for care of the exit site are provided, emphasizing the importance of keeping the area clean and dry. Patients may be advised on signs of infection to watch for, such as increased redness, swelling, or discharge. Follow-up appointments are typically scheduled to assess the function of the extension and to ensure that the intraperitoneal access remains patent and effective for its intended use.
| Short Descr | INSERT SUBQ EXTEN TO IP CATH | Medium Descr | INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER | Long Descr | Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | 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 | 99 - Other OR gastrointestinal therapeutic procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure 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 |
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| 2007-01-01 | Added | First appearance in code book in 2007. |
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