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2025 CPT code 49419

Surgical insertion of a catheter within the abdominal cavity and creation of a subcutaneous pocket to house a reservoir for drug delivery.

Modifiers may be applicable to this code to indicate specific circumstances, such as increased procedural services (22), multiple procedures (51), or reduced services (52).Always consult current CPT guidelines for appropriate modifier usage.

Medical necessity for this code is established by the underlying condition requiring intraperitoneal drug delivery.This might include abdominal cancers, chronic pain conditions, or infections like peritonitis.The documentation should clearly demonstrate that less invasive methods are unsuitable.

The physician preps and anesthetizes the patient, makes incisions to create a pocket for the reservoir, inserts and secures the reservoir, places the catheter, tunnels it to the peritoneum, and closes the incisions. Imaging guidance may be used.

IMPORTANT:For percutaneous insertion, see 49418. For laparoscopic insertion, see 49324. For open insertion for dialysis, see 49421. For removal, see 49422.

In simple words: A surgeon places a small tube and a reservoir under the skin of the abdomen. The tube delivers medicine directly into the abdominal cavity from the reservoir. This is often used for chemotherapy or other medications.

The provider surgically inserts a catheter within the abdominal cavity and creates a subcutaneous pocket in the fascia of the rectus muscle to hold a reservoir for drugs or therapeutic agents.The tunneled catheter delivers the drug from the subcutaneous reservoir into the cavity. This procedure establishes a delivery system for chemotherapy drugs in patients with abdominal cancer, or for other drugs like insulin or morphine.

Example 1: A patient with advanced ovarian cancer requires intraperitoneal chemotherapy., A patient with chronic pain requires continuous delivery of pain medication into the abdominal cavity., A patient undergoing treatment for peritonitis requires targeted drug delivery.

Documentation should include the operative report detailing the procedure, type of catheter and reservoir used, location of placement, method of insertion, use of imaging guidance, and any complications.Medical necessity should be supported by documentation of the diagnosis requiring intraperitoneal drug delivery.

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