2025 CPT code 49020
(Active) Effective Date: N/A Revision Date: N/A Surgery - Incision Procedures Surgical Procedures on the Abdomen, Peritoneum, and Omentum Feed
Open drainage of a peritoneal abscess or localized peritonitis (excluding appendiceal abscess).
Modifiers may apply depending on the circumstances. Modifier 59 (distinct procedural service) may be used if appropriate.Other modifiers may be needed to reflect the specific situation (e.g., 22 for increased procedural services).
Medical necessity is established by documentation showing the presence of a significant peritoneal abscess or localized peritonitis requiring surgical drainage. The symptoms and signs must support the need for intervention, and the procedure must be performed according to accepted medical standards.
The surgeon is responsible for the entire procedure, including preoperative preparation, incision, exploration of the abdomen, identification and drainage of the abscess, irrigation, culture collection, potential placement of a drain, and wound closure.
- Surgical Procedures on the Abdomen, Peritoneum, and Omentum
- Incision Procedures on the Abdomen, Peritoneum, and Omentum
In simple words: The doctor makes an incision in your abdomen to drain an infected area. This is done to remove pus and treat an infection in the membrane that lines your abdominal cavity. This procedure does not involve the appendix.
This procedure involves an open surgical incision into the abdomen to drain an abscess or area of localized peritonitis within the peritoneal cavity.The procedure excludes drainage of appendiceal abscesses. It includes exploration of the abdominal cavity, identification and culture of infectious material, removal of purulent material, irrigation with an antibiotic solution, and potential placement of a drainage tube. Wound closure or packing may be performed depending on the situation.
Example 1: A patient presents with symptoms of peritonitis following a ruptured diverticulum.An open surgical procedure is performed to drain the resulting abscess., A patient undergoes a colectomy, and during the procedure, a separate abdominal abscess is discovered and drained.Code 49020 would be used in addition to the colectomy code, potentially with modifier 59 if the drainage represents a distinct procedural service., A patient presents with a localized peritoneal abscess secondary to a pelvic inflammatory disease.Laparotomy is performed, and the abscess is drained.Culture is obtained.
* Complete history and physical examination documenting symptoms consistent with peritoneal abscess or peritonitis.* Operative report detailing the incision, exploration of the abdominal cavity, location and size of the abscess, description of drainage, amount of purulent material, type of irrigation used, placement of drains (if applicable), and wound closure technique.* Microbiology reports of any cultures obtained.* Pathology report, if tissue specimens were sent.* Any imaging studies performed (e.g., CT scan) to identify the abscess location.
** Accurate coding requires meticulous documentation.Consult with a coding specialist if you have any questions or uncertainties regarding the use of this code in specific clinical scenarios.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not available in the provided sources.Consult the CMS fee schedule for current RVU values.
- Global Days : The global period for this procedure varies depending on payer and other factors.Consult the specific payer's guidelines.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable to this code.
- Fee Schedule : Historical fee schedule data is not available in the provided sources.Consult historical CMS fee schedules or other relevant databases for this information.
- Specialties:General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center