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2025 CPT code 58822

Drainage of ovarian abscess via abdominal approach.

Follow all CPT coding guidelines for surgical procedures.Ensure proper documentation to support medical necessity and accurately reflect the services performed.

Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT codebook and local payer guidelines.

Medical necessity for surgical drainage of an ovarian abscess is established when conservative management (antibiotics) fails to resolve the infection, the abscess is symptomatic (causing significant pain or other complications), or there is a risk of rupture or sepsis.

The provider is responsible for performing the entire procedure including anesthesia administration, incision, drainage of the abscess, irrigation, placement of drains, and closure of the incision.

IMPORTANT:For transrectal image-guided fluid collection drainage by catheter of pelvic abscess, use 49407. For pelvic laparotomy, use 49000. For excision or destruction of endometriomas, open method, see 49203-49205, 58957, 58958. For paracentesis, see 49082, 49083, 49084. For secondary closure of abdominal wall evisceration or disruption, use 49900. For fulguration or excision of lesions, laparoscopic approach, use 58662. For chemotherapy, see 96401-96549.

In simple words: The doctor drains a pus-filled pocket (abscess) in the ovary through a cut in the belly.The area is cleaned, and a tube may be left to drain fluid. The belly is then stitched closed.

This procedure involves draining an ovarian abscess through an abdominal incision. The patient is placed in the supine position under general anesthesia.A midline or low transverse abdominal incision is made to access the abdomen. The bowel is retracted, and the pelvis and abdomen are explored to locate the abscess. The abscess is incised and drained, followed by irrigation with sterile saline. One or more drains are placed into the abscess cavity, exteriorized through a small abdominal incision, and possibly sutured to the skin. The abdominal incision is then closed with sutures.

Example 1: A 32-year-old female presents with lower abdominal pain, fever, and elevated white blood cell count.Ultrasound reveals a large tubo-ovarian abscess.After antibiotic treatment fails to resolve the infection, laparotomy with drainage of the abscess is performed., A 28-year-old female with a history of pelvic inflammatory disease develops a symptomatic ovarian abscess. Conservative management with antibiotics is unsuccessful.Surgical drainage via laparotomy is indicated to alleviate symptoms and prevent complications., A 40-year-old female undergoing a laparotomy for unrelated gynecological issues is found to have a large ovarian abscess.Intraoperative drainage is performed to address the abscess during the existing procedure.

* Preoperative diagnosis (including imaging findings)* Operative report detailing the procedure (incision type, abscess location, drainage technique, drain placement)* Pathology report (if applicable)* Postoperative course and recovery notes* Documentation of failed conservative management (antibiotics) if applicable.

** The approach to drainage (laparotomy) is specified in the code.Other approaches (e.g., laparoscopy, percutaneous drainage) would necessitate different CPT codes.Accurate documentation is critical for appropriate reimbursement.

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