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2025 CPT code 49325

Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed.

Code 49325 is used for laparoscopic revision of a previously placed intraperitoneal cannula or catheter, including removal of intraluminal obstructive material. If omentopexy (omental tacking) is also performed, add-on code +49326 should be reported. This code does not include initial placement of a peritoneal dialysis catheter.

Modifiers may be applicable, such as 22 (Increased Procedural Services), 52 (Reduced Services), 59 (Distinct Procedural Service), 78 (Unplanned Return to the Operating/Procedure Room), or 79 (Unrelated Procedure or Service by the Same Physician).The specific modifier used depends on the circumstances of the procedure.

Medical necessity for this procedure must be supported by documentation demonstrating impaired peritoneal dialysis function (e.g., inadequate outflow, abdominal pain, clinical signs of inadequate dialysis) and the need for surgical intervention to restore catheter function.

The physician is responsible for the entire procedure, including prepping the patient, administering anesthesia, making the incisions, insufflating the abdomen, inserting the laparoscope and instruments, examining the catheter, removing any obstructions, repositioning or replacing the catheter if needed, ensuring hemostasis, removing the instruments, and closing the surgical wounds.

IMPORTANT:+49326 for laparoscopic omentopexy performed during the same procedure.49422 for removal of a tunneled intraperitoneal catheter.Evaluation and Management (E/M) codes for removal of non-tunneled catheters.

In simple words: The doctor uses a small camera and tools inserted through tiny cuts in your belly to fix a blocked or misplaced tube inside your abdomen. This tube helps with dialysis.The doctor will check the tube, fix its position, clear any blockages, and make sure it works properly.

This procedure involves laparoscopic access to the abdominal cavity to revise a previously placed intraperitoneal cannula or catheter.The procedure includes removing any intraluminal obstructive material if found.The surgeon makes small incisions, insufflates the abdomen, and uses specialized instruments to visualize and manipulate the catheter.The catheter is examined for damage, may be repositioned or partially replaced, and any blockages within the catheter are removed.The surgeon confirms catheter function before closing the incisions.

Example 1: A patient on peritoneal dialysis experiences outflow problems.Laparoscopy reveals omental adhesions obstructing the catheter. The adhesions are lysed, and the catheter function is restored., A patient's peritoneal dialysis catheter is found to be malpositioned during a routine check-up, causing inadequate dialysis. Laparoscopic revision is performed to reposition the catheter correctly., A patient presents with abdominal pain and reduced dialysis flow. Laparoscopy identifies a fibrin clot obstructing the lumen of the catheter.The clot is removed, and the catheter is flushed to restore function.

Documentation should include operative notes detailing the laparoscopic findings (e.g., adhesions, obstructions, catheter position), the procedure performed (e.g., lysis of adhesions, removal of obstruction, repositioning/replacement of catheter), and confirmation of restored catheter function. Pre- and post-procedure dialysis flow rates should also be documented.

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