2025 CPT code 49442
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Initial Placement Procedures on the Abdomen, Peritoneum, and Omentum Surgical Procedures on the Digestive System Feed
Percutaneous insertion of a cecostomy or other colonic tube under fluoroscopic guidance, including contrast injections, image documentation, and report.
Modifiers may be applicable depending on circumstances such as multiple procedures (51), reduced services (52), or assisting surgeon (80). Consult your payer's specific guidelines.
Medical necessity for a percutaneous cecostomy or colonic tube placement is established when conservative measures fail to address severe constipation or fecal incontinence.The procedure may also be medically necessary for bowel decompression or nutritional support in the context of bowel obstruction or other gastrointestinal conditions.
The physician is responsible for all aspects of the procedure, including patient preparation, anesthesia (if applicable), incision, fluoroscopic guidance, tube placement, and post-procedure care.
- Surgical Procedures on the Digestive System
- Initial Placement Procedures on the Abdomen, Peritoneum, and Omentum
In simple words: The doctor inserts a tube into the large intestine through a small cut in the abdomen using X-ray guidance.This helps treat severe constipation or fecal incontinence.
This procedure involves the percutaneous placement of a cecostomy or colonic tube under fluoroscopic guidance.The physician makes a small incision in the abdominal wall, identifies the cecum or colon under fluoroscopy, punctures the intestinal wall with a needle, inserts a guidewire, removes the needle, dilates the tract, and inserts the cecostomy or colonic tube, securing it in place. Contrast injections may be used to improve visualization.The procedure concludes with the application of sterile dressings. Image documentation and a report are included.
Example 1: A patient presents with severe constipation and fecal incontinence. After conservative treatment fails, the physician performs a percutaneous cecostomy tube placement under fluoroscopic guidance to relieve symptoms., A patient with an obstructing colorectal tumor undergoes a cecostomy tube placement to provide a route for bowel decompression and nutritional support prior to surgical intervention., A patient with a bowel obstruction requiring temporary decompression undergoes placement of a colonic tube using this procedure to allow for decompression before definitive treatment.
* Preoperative assessment including patient history, physical exam, and imaging studies (if any).* Operative report detailing the procedure, including the location of the tube placement, type of tube, use of contrast, and any complications.* Intraoperative images (fluoroscopy) demonstrating proper tube placement.* Postoperative assessment and plan of care.
** Always ensure proper documentation supports medical necessity and the specific procedure performed.Consult your payer's guidelines for specific requirements and local coverage determinations.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: This information is not available in the provided text.Consult the AMA CPT codebook or your payer's fee schedule for RVU values and reimbursement information.
- Global Days : This information is not provided and would depend on payer-specific guidelines and local coverage determinations.
- Payment Status: Active
- Modifier TC rule: This information is not available in the provided text.Consult your payer's guidelines for TC modifier application.
- Fee Schedule : This information is not available in the provided text.Consult historical fee schedules from your payer or the AMA.
- Specialties:General Surgery, Gastroenterology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center