2025 CPT code 44900
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Open incision and drainage of an appendiceal abscess.
Modifiers may be applicable to 44900 depending on the specifics of the case, such as multiple procedures (modifier 51) or increased procedural service (modifier 22).
Medical necessity for incision and drainage of an appendiceal abscess is established by the presence of a symptomatic abscess confirmed by imaging studies such as CT scan or ultrasound. The procedure is medically necessary to relieve pain, prevent sepsis, and facilitate healing.Failure to drain the abscess can lead to significant morbidity and mortality.
The surgeon is responsible for prepping the patient, making the incision, identifying and incising the abscess, draining the pus, placing a drain if necessary, controlling bleeding, closing the incision, and ensuring appropriate postoperative care.
In simple words: The doctor cuts open an infected pocket near the appendix to drain the pus and relieve pain.A tube might be left in place to help drain any remaining pus.
This CPT code, 44900, describes the open surgical procedure of incising and draining an appendiceal abscess.The procedure involves making an incision in the right lower abdomen to access and open the abscess pocket, allowing the drainage of purulent material.A drainage tube may be placed to facilitate continued drainage. The incision is then closed in layers.This is distinct from percutaneous image-guided drainage (CPT 49406).
Example 1: A 30-year-old male presents with right lower quadrant pain, fever, and elevated white blood cell count. Imaging reveals a localized appendiceal abscess.The surgeon performs an open incision and drainage of the abscess, placing a drain., A 25-year-old female with a history of Crohn's disease develops an appendiceal abscess.She undergoes an open incision and drainage with placement of a drain.The procedure is complicated by significant adhesion formation., A 55-year-old male presents with a perforated appendix and a large associated abscess. The surgeon performs an appendectomy and open incision and drainage of the abscess, placing a drain.
Complete medical history including the symptoms leading to the diagnosis, the results of the imaging studies confirming the presence of the abscess, operative report detailing the incision site, drainage techniques, amount of pus drained, and any complications encountered, pathology report if any tissue was sent for analysis, and postoperative recovery progress.
** Accurate coding of 44900 requires precise documentation differentiating it from percutaneous drainage (49406).Consider potential modifiers depending on the complexity of the procedure and the presence of other surgical procedures.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Specialties:General Surgery, Colorectal Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center