Summary & Overview
CPT 49014: Reopening Pelvic Cavity and Removal of Preperitoneal Packing
CPT code 49014 denotes the surgical reopening of the pelvic cavity to remove absorbent packing from the preperitoneal space, with possible repacking if bleeding continues. This code captures a focused operative management step in patients who previously underwent pelvic packing for hemorrhage control, making it relevant to trauma, emergency general surgery, and perioperative services nationwide.
Key payers commonly relevant to coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The code is important for hospitals and surgical teams because it documents a distinct, resource-intensive re-exploration procedure that may affect reimbursement, utilization tracking, and quality reporting.
Readers will find clinical context for when this procedure is used, the typical site of service, and how it fits within perioperative management of pelvic hemorrhage. The publication provides benchmarks where available, notes on coding practice considerations, and policy-related updates that affect national billing and documentation standards. Data not available in the input will be identified as such in the detailed sections.
Billing Code Overview
CPT code 49014 describes reopening the pelvic cavity to remove previously placed absorbent packing material from the preperitoneal space, with the option to repack if bleeding persists. This procedure is a surgical intervention performed after initial pelvic packing, typically in the context of controlling pelvic hemorrhage.
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Service type: Surgical wound reopening and removal of packing in the preperitoneal/pelvic space
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Typical site of service: Operating room or other surgical suite where abdominal/pelvic re-exploration is performed
Clinical & Coding Specifications
Clinical Context
A patient who previously underwent an open pelvic or lower abdominal operation returns to the operating room for exploration of the preperitoneal space to remove previously packed absorbent pads used for hemorrhage control. Typical presentation includes postoperative monitoring in PACU or ICU with continued hemodynamic instability, ongoing drainage from the surgical site, or concern for retained packing. The workflow begins with assessment of vitals and labs, review of operative notes documenting prior packing, informed consent for re-exploration under general anesthesia, repeat abdominal/pelvic incision reopening, removal of packing material from the preperitoneal space, inspection for ongoing bleeding, and either final hemostasis or repacking if bleeding persists. Typical monitoring includes serial hemoglobin/hematocrit, transfusion as indicated, and possible admission to intensive care post-procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No Modifier (default) | When no other modifier applies and standard circumstances exist |
11 | Normal service | To indicate the service was performed as normally expected |