Summary & Overview
CPT 49324: Laparoscopic Peritoneal Catheter Placement for Ascites Drainage
CPT code 49324 identifies a laparoscopic procedure to place a peritoneal catheter for long-term drainage of ascites, a common complication of liver disease and abdominal cancers. Nationally, this code is relevant to hospitals, ambulatory surgery centers, and gastroenterology or surgical practices managing recurrent or refractory ascites where durable drainage solutions are needed.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the service type tied to the code. The publication outlines billing and coding context, commonly observed modifier usage (input list provided), and payer coverage patterns where available. It also summarizes operational considerations for facilities and clinicians performing laparoscopic catheter placement, such as expected settings and procedural intent.
The material is designed for coding professionals, practice managers, and clinicians seeking a clear, national-level reference for CPT code 49324 — including clinical rationale for the procedure, typical care settings, and the kinds of documentation and charge lines associated with laparoscopic peritoneal catheter placement for ascites drainage.
Billing Code Overview
CPT code 49324 describes a laparoscopic procedure in which the provider inspects the peritoneal cavity using a laparoscope and places a catheter into the peritoneal (abdominal) lining to provide long-term drainage of ascites. This procedure addresses accumulation of fluid in the peritoneal cavity commonly seen with advanced liver disease and certain abdominal malignancies.
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Service type: Laparoscopic peritoneal catheter placement for ascites drainage
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Typical site of service: Operating room or procedure suite in an ambulatory surgery center or hospital setting
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with decompensated cirrhosis presents with recurrent symptomatic ascites causing abdominal distension, dyspnea, and early satiety despite serial therapeutic paracenteses and optimized diuretic therapy. The hepatology and interventional surgery teams evaluate the patient for placement of a tunneled peritoneal drainage catheter to allow long-term outpatient drainage of ascites. The procedure is performed in an operating room or procedure suite under monitored anesthesia care or general anesthesia. The surgeon performs a diagnostic laparoscopy to visualize the peritoneal cavity, lyses adhesions as needed, and places a tunneled peritoneal catheter with an intraperitoneal cuff to establish long-term drainage and reduce infection risk. Post-procedure workflow includes sterile dressing, catheter flushing and securement, patient and caregiver education on home drainage technique, scheduling outpatient drain management, and documentation of informed consent, indication, intraoperative findings, and any complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services | Use when work required is substantially greater than usual (extensive adhesiolysis during laparoscopy). |
23 |