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2025 CPT code 49323

Laparoscopic surgical drainage of a lymphocele into the peritoneal cavity.

Surgical laparoscopy always includes diagnostic laparoscopy. Code 49320 (diagnostic laparoscopy) should be used separately only if it's a distinct service in addition to the drainage procedure.

Modifiers such as 22 (increased procedural services), 51 (multiple procedures), and 59 (distinct procedural service) may be applicable depending on the circumstances of the procedure. Refer to the CPT manual for guidance on modifier use.

Medical necessity for laparoscopic lymphocele drainage is established when the lymphocele causes significant pain, pressure, or risk of infection. Documentation needs to clearly justify the need for the procedure and demonstrate that less invasive options have been considered and ruled out.

The surgeon is responsible for pre-operative preparation, anesthesia administration (if applicable), making the incisions, inserting the laparoscope and instruments, identifying and opening the lymphocele, draining the fluid, irrigating the area, checking for bleeding, removing instruments and closing the incisions. Post-operative care and follow-up are also the surgeon's responsibility.

IMPORTANT For open drainage of a lymphocele to the peritoneal cavity, use CPT code 49062.If a diagnostic laparoscopy is performed in addition to the drainage, CPT code 49320 may also be reported as a separate procedure.

In simple words: The doctor uses a small camera and instruments inserted through tiny cuts in the belly to drain a fluid-filled sac. This sac, called a lymphocele, is a pocket of fluid that sometimes forms after surgery or injury and causes pain. The fluid is drained into the abdomen's natural cavity, relieving pain and reducing the risk of infection.

This procedure involves a laparoscopic approach to drain a lymphocele (a collection of lymphatic fluid) into the peritoneal cavity.The surgeon makes small incisions, inserts a laparoscope and instruments, identifies the lymphocele, opens it to allow drainage, and may irrigate the area with an antibiotic solution.The incisions are then closed.

Example 1: A patient presents with post-surgical pelvic pain and a palpable mass.Laparoscopic examination reveals a lymphocele. The surgeon performs a laparoscopic drainage, relieves the patient's pain, and reduces the infection risk., After extensive abdominal trauma, a patient develops a lymphocele causing discomfort.A laparoscopic drainage is performed to relieve pressure and pain. The lymphocele contents are cultured and antibiotic irrigation is given., A patient has a known lymphocele following a prior gynecologic laparotomy. The lymphocele shows evidence of infection based on physical exam and laboratory work.The surgeon performs a laparoscopic drainage and irrigates the area with antibiotics under general anesthesia.

** Always refer to the latest CPT manual and payer guidelines for the most up-to-date coding and reimbursement information.This information is current as of December 3, 2024.

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