Summary & Overview
CPT 1022T: Image-Guided Percutaneous Intra‑abdominal/Pelvic Tissue Displacement
CPT code 1022T is an add-on code that captures the image-guided, percutaneous displacement of intra-abdominal or pelvic tissue performed to protect adjacent structures while a primary procedure is completed. This procedure is clinically significant because it documents an additional, imaging-directed intervention that facilitates safer access to surgical targets and reduces the risk of injury to organs or vasculature. Nationally, proper coding of this add-on supports accurate resource reporting and informs reimbursement for complex, image-guided procedural care. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what CPT code 1022T represents, the clinical context in which it is used, typical sites of service, and which major payers are considered in coverage discussions. The publication provides benchmarks where available, highlights payment policy considerations for an add-on imaging-guided displacement service, and summarizes clinical implications for documentation and coding workflows. Data not available in the input for specific modifiers, associated taxonomies, ICD-10 pairings, related codes, service lines, and payer-specific reimbursement amounts.
Billing Code Overview
CPT code 1022T describes an add-on percutaneous procedure to reposition intra-abdominal or pelvic tissue to protect or displace structures so a primary procedure can be performed safely. The service is performed using imaging guidance to ensure accurate and safe displacement of organs or tissues.
Service Type: Image‑guided percutaneous tissue displacement (add-on)
Typical Site of Service: Hospital operating room, interventional radiology suite, or other procedural setting where image guidance is available
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old woman with a history of recurrent ovarian cysts is scheduled for laparoscopic ovarian cystectomy. Preoperative imaging demonstrates a cyst abutting loops of small bowel and mesentery that could obstruct safe access to the target ovary. During the primary laparoscopic procedure, the surgeon requests percutaneous, image-guided mobilization of intra-abdominal tissue to create a safe working corridor and protect adjacent bowel and vascular structures while the cyst is excised.
The workflow begins with the patient under general anesthesia in the operating room or interventional suite. Using ultrasound or fluoroscopic guidance, the interventionalist places a percutaneous instrument or catheter and displaces the bowel or omentum away from the operative field. Real-time imaging confirms adequate displacement and absence of injury to surrounding structures. Once safe separation is achieved, the operating surgeon proceeds with the primary procedure (laparoscopic cystectomy). The add-on maneuver is documented separately, noting imaging modality, percutaneous approach, structures displaced, duration, and that the action facilitated the primary procedure without causing injury.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct Procedural Service | When the displacement maneuver is a separate and distinct service from the primary procedure and documentation supports a distinct procedural service. |
76 | Repeat Procedure by Same Physician | If the percutaneous displacement procedure is repeated during the same operative session by the same provider. |
77 | Repeat Procedure by Another Physician | If a different provider repeats the percutaneous displacement during the same session. |
52 | Reduced Services | When the displacement procedure is partially performed or limited compared with full typical performance. |
53 | Discontinued Procedure | If the displacement attempt was started but discontinued due to an intra-procedural complication or inability to safely complete. |
22 | Increased Procedural Services | When substantially greater work is performed than typical and documentation supports increased complexity for the displacement maneuver. |
24 | Unrelated E/M Service by the Same Physician During a Postoperative Period | If an unrelated evaluation is provided during the postoperative period of the primary procedure (used cautiously, not to link to the add-on) |
25 | Significant, Separately Identifiable E/M Service on Same Day | If a separate E/M service is provided on the same day as the surgical encounter in addition to the displacement procedure. |
RT | Right Side | When the percutaneous displacement specifically involves right-sided intra-abdominal structures and laterality is reportable per payer rules. |
LT | Left Side | When the percutaneous displacement specifically involves left-sided intra-abdominal structures and laterality is reportable per payer rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | General Surgery | Surgeons performing intra-abdominal operations who may request or perform percutaneous tissue displacement to facilitate laparoscopy. |
| 2080P0005X | Colon and Rectal Surgery | Specialists who may use displacement techniques when mobilizing bowel or working near the rectum. |
| 208600000X | Obstetrics and Gynecology | Gynecologic surgeons performing laparoscopic pelvic procedures where bowel or adnexa require displacement. |
| 174400000X | Interventional Radiology | Image-guided percutaneous specialists who may perform safe displacement using ultrasound or fluoroscopy. |
| 282N00000X | Surgical Oncology | Surgeons operating on intra-abdominal tumors who may need adjunctive percutaneous displacement for safe resection. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
K57.30 | Diverticulosis of large intestine without perforation or abscess | Large bowel segments near the surgical field may require displacement to prevent injury during pelvic or intra-abdominal procedures. |
N83.2 | Ovarian cyst, ruptured | Ovarian pathology that commonly prompts laparoscopic intervention where adjacent bowel may need to be displaced. |
N83.20 | Ovarian cyst, unspecified | Indicative of adnexal masses or cysts that may obstruct access and necessitate tissue displacement for safe excision. |
K35.80 | Acute appendicitis, unspecified with other complication | Inflamed appendix or periappendiceal inflammation can obscure operative access; displacement aids visualization and protection of bowel. |
C56.9 | Malignant neoplasm of ovary, unspecified | Gynecologic oncology cases where safe exposure and protection of surrounding structures are critical during resection and may require adjunctive displacement. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
49320 | Laparoscopy, surgical; with biopsy (single or multiple) | Common primary laparoscopic procedure during which percutaneous tissue displacement may be used to protect bowel and improve access for biopsy. |
58662 | Laparoscopy, surgical, with removal of adnexal structures (partial/total oophorectomy) | A gynecologic operative procedure that may require adjunctive percutaneous displacement to safely visualize and remove ovarian pathology. |
49000 | Exploration of peritoneal cavity, exploratory laparotomy, without biopsy (separate procedure) | Open abdominal exploration that may follow or accompany displacement maneuvers in complex cases where laparoscopy is not feasible. |
76937 | Ultrasound guidance for aspiration and/or biopsy of abdominal or pelvic lesion(s); percutaneous | Imaging-guidance CPT code type that describes real-time ultrasound localization—often used concurrently to guide percutaneous displacement. |
77002 | Fluoroscopic guidance for needle placement (e.g., for biopsy, aspiration) | Fluoroscopic guidance code used when displacement is performed under fluoroscopy to ensure safe instrument trajectory and tissue separation. |