Summary & Overview

CPT 49322: Laparoscopic Aspiration of Intra-Abdominal Fluid/Cysts

CPT code 49322 identifies laparoscopic aspiration of intra-abdominal fluid collections, commonly applied to cyst drainage such as ovarian cyst aspiration to prevent rupture and hemorrhage. This code captures a minimally invasive combination of inspection and fluid removal that can be diagnostic and therapeutic in a single encounter. Nationally, procedures billed under 49322 matter because they intersect surgical specialty care, ambulatory surgery utilization, and perioperative resource planning for gynecologic and general surgical practices.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, guidance on typical sites of service, and which payer populations are most relevant for coverage and claims considerations. The publication also outlines common billing and coding themes associated with laparoscopic aspiration procedures.

What readers will learn: the clinical role of CPT code 49322, the typical care settings where it is performed, payer coverage landscape at a national level, and practical considerations for coding and claims submission. Data not provided in the source are explicitly noted as unavailable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 49322laparoscopyovarian cyst aspirationminimally invasive surgeryambulatory surgerysurgical codingprocedure codingintra-abdominal fluid

Billing Code Overview

CPT code 49322 describes a diagnostic and therapeutic laparoscopic aspiration of intra-abdominal fluid collections, such as aspiration of ovarian cysts to prevent rupture and internal bleeding. The procedure uses a laparoscope — a tubular instrument with a light source and camera — to visualize the abdominal cavity and withdraw fluid from one or more pockets or sacs.

Service Type: Laparoscopic diagnostic/therapeutic procedure (aspiration of intra-abdominal fluid/cysts)

Typical Site of Service: Hospital operating room or ambulatory surgery center with laparoscopic capability

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 32-year-old premenopausal woman presents to the emergency department with acute onset lower abdominal pain, nausea, and pelvic fullness. Pelvic ultrasound demonstrates a 6 cm complex ovarian cyst with free pelvic fluid and concern for torsion or impending rupture. After informed consent, the patient is taken to the operating room for a diagnostic and operative laparoscopy. Using a laparoscope, the surgeon inspects the peritoneal cavity and visualizes an ovarian cyst with fluid-filled locule(s). The surgeon aspirates the cyst contents through a laparoscopic needle or trocar under direct visualization to decompress the cyst, reduce the risk of rupture, and evaluate ovarian viability. Specimens of cyst fluid may be sent for cytology if indicated. Hemostasis is confirmed, and the abdomen is irrigated and closed.

Typical site of service

Ambulatory surgery center or hospital outpatient operating room for elective or urgent cases

Clinical workflow steps

Preoperative evaluation, informed consent, and anesthesia (general anesthesia typical)
Laparoscopic entry, diagnostic survey of abdominal and pelvic organs
Targeted aspiration of cystic fluid from one or more ovarian cysts using laparoscopic instruments (CPT 49322)
Adjunctive procedures as needed (lysis of adhesions, cystectomy, hemostasis)
Specimen handling if fluid or tissue sent to pathology
Post-anesthesia recovery and discharge or admission based on clinical status

Coding Specifications

Modifier	Description	When to Use
`50`	Bilateral procedure	Use when the same laparoscopic aspiration is performed on both ovaries during the same session
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned
`53`	Discontinued procedure	Use when the procedure is started but terminated for patient-related or safety reasons
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure on the same day not normally bundled
`62`	Two surgeons	Use when two surgeons work together as primary surgeons throughout the procedure
`66`	Surgical team (multiple surgeons)	Use when services are provided by a surgical team under a published arrangement
`78`	Return to OR for related procedure during global period	Use when an unplanned return to the operating room occurs for a related procedure during the global period
`79`	Unrelated procedure during global period	Use when an additional procedure unrelated to the original operation is performed during the global period
`51`	Multiple procedures	Use when multiple distinct procedures are performed in the same operative session (list in correct order)
`22`	Increased procedural services	Use when work required is substantially greater than typically required for the procedure
`26`	Professional component	Use if reporting the professional interpretive component separately from technical services (rare for this code)
`73`	Discontinued outpatient hospital/ASC procedure prior to anesthesia	Use when procedure is discontinued before anesthesia is administered
`74`	Discontinued outpatient hospital/ASC procedure after anesthesia	Use when procedure is discontinued after anesthesia is administered (note: `74` is not in provided list; omitted)

Taxonomy Code	Specialty	Notes
207Q00000X	Obstetrics & Gynecology	Gynecologic surgeons commonly perform laparoscopic ovarian cyst aspiration or related procedures
2080P0003X	General Surgery	General surgeons with laparoscopic expertise may perform diagnostic laparoscopy and cyst aspiration in certain settings
207R00000X	Reproductive Endocrinology/Infertility	Specialists may aspirate cysts in fertility-related contexts or for ultrasound-guided procedures
363L00000X	Gynecologic Oncology	Gynecologic oncologists perform diagnostic laparoscopy and aspiration when malignancy is a concern
207K00000X	Family Medicine (Obstetrics)	In some rural or limited-resource settings, family medicine physicians with procedural training may perform laparoscopic procedures

ICD-10 Code	Description	Clinical Relevance
`N83.2`	Follicular cyst of ovary	Common benign ovarian cyst that may be aspirated to relieve pain or prevent rupture
`N83.1`	Hemorrhagic ovarian cyst	Cyst with internal bleeding; aspiration can decompress and control symptoms if indicated
`N83.3`	Other and unspecified ovarian cysts	Captures cysts not otherwise specified that may require aspiration
`N83.8`	Other noninflammatory disorders of ovary, fallopian tube and broad ligament	Includes various cystic lesions where aspiration may be therapeutic or diagnostic
`N97.9`	Female infertility, unspecified	In certain fertility procedures, cyst aspiration may be part of management (e.g., endometrioma drainage)

CPT Code	Description	Relationship to This Procedure
`49320`	Laparoscopy, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)	Performed when a diagnostic survey of the abdomen/pelvis is required prior to or together with aspiration to evaluate other pathology
`58662`	Laparoscopy, surgical, with removal of adnexal structures (partial or total oophorectomy; unilateral or bilateral)	Performed when cyst aspiration is insufficient and definitive removal of the cyst or ovary is indicated during the same or subsequent operation
`58661`	Laparoscopy, surgical; with removal/ligation of fallopian tube(s) (salpingectomy)	May be performed if adjunctive tubal procedure is needed during gynecologic laparoscopic surgery
`49000`	Exploratory laparoscopy, diagnostic, with or without biopsy or celiotomy	Alternative diagnostic code for abdominal exploration; used depending on payer or specific service documentation
`76942`	Ultrasonic guidance for biopsies (e.g., imaging guidance)	Used if intraoperative ultrasound guidance is used to localize the cyst for aspiration

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