CPT code 49411 is for the insertion of a catheter into the abdomen or pelvis for drainage, specifically for the right side.
CPT code 49411 is used to describe the procedure of inserting a catheter into the abdominal or pelvic cavity for the purpose of placing a drainage device. This specific code indicates that the procedure is performed on the right side of the body and is done percutaneously, meaning it is done through the skin with minimal incisions. This code is typically utilized in cases where fluid accumulation needs to be managed, such as in the treatment of abscesses or other fluid collections.
For CPT code 49411, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services
- Used when the work required to provide a service is substantially greater than typically required.
2. Modifier 26 - Professional Component
- Indicates that the service provided was the professional component only, such as the interpretation of a diagnostic test.
3. Modifier 52 - Reduced Services
- Used when a service or procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 53 - Discontinued Procedure
- Indicates that a procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
5. Modifier 59 - Distinct Procedural Service
- Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician
- Indicates that a procedure or service was repeated by the same physician or other qualified healthcare professional subsequent to the original procedure or service.
7. Modifier 77 - Repeat Procedure by Another Physician
- Indicates that a procedure or service was repeated by another physician or other qualified healthcare professional subsequent to the original procedure or service.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
- Used when a patient returns to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
- Indicates that the performance of a procedure or service during the postoperative period was unrelated to the original procedure.
10. Modifier 80 - Assistant Surgeon
- Used when an assistant surgeon is required during a procedure.
11. Modifier 81 - Minimum Assistant Surgeon
- Indicates that a minimum assistant surgeon was required during the procedure.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available)
- Used when an assistant surgeon is required, and a qualified resident surgeon is not available.
13. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test
- Indicates that a clinical diagnostic laboratory test was repeated on the same day to obtain subsequent test results.
14. Modifier 99 - Multiple Modifiers
- Used when two or more modifiers are necessary to describe the service provided.
These modifiers help provide additional information about the performed procedure, ensuring accurate billing and reimbursement.
CPT code 49411 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating that it is a covered service. However, reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) and local coverage determinations. Healthcare providers should consult their regional MAC for specific coverage and payment guidelines related to CPT 49411.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can effortlessly read your contracts and detect underpayments down to the CPT code level, including specific codes like 49411, and by individual payer. Don't leave money on the table—schedule a demo today to see how RevFind can optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
