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2025 CPT code 49320

Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure).

Code 49320 is reported only when no therapeutic treatment is performed during the same session. If a therapeutic procedure is performed, the diagnostic laparoscopy is included in the therapeutic procedure code.If no disease is found or the disease is too extensive for surgical treatment, 49320 can be reported separately.

Modifiers can be applied to 49320 to indicate specific circumstances. For instance, modifier 52 (Reduced Services) would be used if the procedure was incomplete, modifier 22 (Increased Procedural Services) if the procedure was significantly more complex than usual, and modifier 59 (Distinct Procedural Service) is used to distinguish 49320 from other procedures performed during the same session that are normally bundled.

Medical necessity is established by the presence of signs, symptoms, or other clinical findings suggestive of intra-abdominal pathology that cannot be definitively diagnosed by less invasive means. Diagnostic laparoscopy is indicated when less invasive procedures like imaging studies fail to provide a diagnosis or when a tissue sample is needed for definitive diagnosis.

After anesthesia and preparation, a small incision is made at the navel to inflate the abdomen and improve visibility. Another small incision allows insertion of the camera and instruments.Fluid is suctioned, organs are examined, and suspicious areas are brushed and washed for lab analysis. The area is irrigated, bleeding checked, instruments removed, and incisions closed.

In simple words: The doctor looks inside your belly with a tiny camera on a tube to see why you have pain, swelling, or other problems. They check the lining of your belly and the fatty tissue covering your organs. They might also take some cells to test.

This procedure involves examining the inside of the abdomen using a laparoscope, a thin tube with a light and camera, to identify causes of abdominal symptoms like pain, swelling, or organ enlargement. The peritoneum (abdominal lining) and omentum (fatty tissue covering the organs) are inspected. Brushing and washing may be done to collect cell samples for analysis.

Example 1: A patient presents with chronic abdominal pain of unknown origin. Diagnostic laparoscopy (49320) is performed to visualize the abdominal structures and rule out conditions like appendicitis, cholecystitis, or other abnormalities., A patient with ascites (fluid in the abdomen) undergoes laparoscopy (49320) with brushing and washing of the peritoneum to collect samples for cytological examination, helping determine the cause of ascites, such as infection or malignancy., A patient with suspected peritoneal carcinomatosis (cancer spread to the abdominal lining) undergoes diagnostic laparoscopy (49320) to visualize the extent of the disease and obtain biopsies for confirmation, guiding treatment decisions.

Documentation should include operative report detailing visualization of the peritoneum and omentum, any procedures performed (brushing/washing), and findings.Pre-operative diagnostic tests and medical necessity for the procedure should also be documented.

** It's crucial to differentiate between diagnostic laparoscopy (49320) and therapeutic laparoscopy, where treatment is performed during the same procedure.Always refer to current CPT coding guidelines for the most accurate reporting. Use of iFrameAI ensures the accuracy of the billing information is up to date.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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