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The CPT® Code 49436 refers to the delayed creation of an exit site from an embedded subcutaneous segment of an intraperitoneal cannula or catheter. This procedure is typically performed after an initial surgical intervention where a portion of the cannula or catheter is placed subcutaneously, starting from the peritoneal cavity. The embedded segment is designed to facilitate the delivery of fluids or medications directly into the peritoneal space, which is the area within the abdomen that houses various organs. The external portion of the cannula or catheter is then threaded through the abdominal wall, ultimately exiting at a remote site, often located in the chest area. This technique is crucial for patients requiring long-term access for therapies such as peritoneal dialysis or other intraperitoneal treatments, ensuring that the cannula remains secure and minimizes the risk of infection or dislodgment.
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The procedure associated with CPT® Code 49436 is indicated for patients who require long-term access to the peritoneal cavity for therapeutic interventions. This may include conditions such as:
The procedure for CPT® Code 49436 involves several critical steps to ensure the successful creation of the exit site for the embedded cannula or catheter. Each step is essential for achieving the desired outcome while minimizing complications.
After the procedure associated with CPT® Code 49436, patients are typically monitored for any immediate complications, such as bleeding or infection at the exit site. Post-procedure care may include instructions on how to care for the exit site, signs of infection to watch for, and guidelines for maintaining the integrity of the cannula or catheter. Patients may also receive education on the importance of keeping the area clean and dry, as well as any restrictions on physical activity to ensure proper healing. Follow-up appointments are usually scheduled to assess the site and the functionality of the cannula or catheter, ensuring that it remains patent and effective for the intended therapeutic use.
| Short Descr | EMBEDDED IP CATH EXIT-SITE | Medium Descr | DELAYED CREATION EXIT SITE EMBEDDED CATHETER | Long Descr | Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter | 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) | 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 | Hospital Part B services paid through a comprehensive APC | 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) | P1G - Major procedure - 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) | 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) |
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| 2007-01-01 | Added | First appearance in code book in 2007. |
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