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2025 CPT code 49427

Injection procedure (e.g., contrast media) for evaluation of a previously placed peritoneal-venous shunt.

unknown

Modifiers may apply based on the circumstances of the procedure (e.g., 22 for increased procedural services, 51 for multiple procedures, 76 for repeat procedure).

Medical necessity for this procedure is established when a previously placed peritoneal venous shunt is suspected to be malfunctioning or blocked, based on clinical presentation (e.g., increased abdominal distension, worsening ascites), imaging studies, or other relevant findings. The procedure aids in diagnosing the cause of shunt dysfunction to guide appropriate management (e.g., shunt revision, replacement, or alternative therapies).

The physician injects contrast material into the peritoneal venous shunt, potentially under radiologic guidance, palpates the abdomen to facilitate contrast flow, and interprets the resulting radiogram to assess shunt patency.

IMPORTANT For radiological supervision and interpretation, see 75809, 78291.

In simple words: The doctor injects a special dye into a tube already placed in the patient's abdomen to check if the tube is working properly and to see if anything is blocking it.

This procedure involves injecting contrast material (dye) into the reservoir of an existing peritoneal venous shunt within the patient's peritoneal cavity.The injection facilitates assessment of the shunt's patency and identifies potential obstructions or defects.The procedure may be performed under radiologic guidance, and the provider might palpate the abdomen to aid contrast flow.A radiogram is subsequently obtained to visualize the contrast's passage through the shunt.

Example 1: A patient with ascites (abdominal fluid buildup) and a previously placed peritoneal venous shunt presents with reduced shunt effectiveness.The physician performs this procedure to assess for obstructions or malfunction., A patient post-liver transplantation has a peritoneal venous shunt to manage ascites. This procedure is performed to evaluate the shunt's functionality and detect any potential blockages that could compromise fluid drainage and increase the risk of complications., A patient with cirrhosis and a history of multiple abdominal surgeries has a peritoneal venous shunt.Before considering revision or replacement, the physician orders this procedure to diagnose any potential issues within the existing shunt system, such as kinks or blockages, before deciding on further interventions.

* Detailed history and physical examination noting the indication for the procedure and the patient's overall condition.* Documentation of the shunt's placement date and type.* Images of the contrast injection and radiogram showing the flow of contrast through the shunt.* Physician's interpretation of the images with findings and recommendations.* Any intra-procedural complications or adverse events.

** This procedure should be distinguished from the placement of a new peritoneal venous shunt (different CPT codes apply).

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