Summary & Overview
CPT 49418: Percutaneous Tunneled Abdominal Catheter Placement
CPT code 49418 denotes percutaneous placement and tunneling of an intraperitoneal catheter for dialysis, ascites drainage, or intraperitoneal chemotherapy. Nationally, this code captures a common interventional radiology procedure used across acute and ambulatory settings to provide long-term access for fluid management and regional therapy. It matters for providers and payers because the code bundles device placement with imaging guidance and radiology supervision and interpretation into a single comprehensive service.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers can expect a concise overview of clinical indications and service settings, typical reimbursement and utilization benchmarks for this service line, and relevant policy or coverage considerations that affect access and billing. The publication highlights coding content, bundling implications due to included imaging and interpretation, and common payer practices nationally.
The piece is aimed at revenue cycle leaders, interventional radiology clinicians, and policy analysts seeking an authoritative description of CPT code 49418, how it is applied in practice, and the payment and coverage themes that shape its use across major payers. Data not available in the input.
Billing Code Overview
CPT code 49418 describes the percutaneous placement and tunneling of a catheter within the abdominal cavity. The procedure is performed for management of dialysis, drainage of ascites, or administration of abdominal chemotherapy and represents a complete procedure that includes catheter placement with imaging guidance, contract injection when performed, and radiology supervision and interpretation.
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Service type: Percutaneous tunneled abdominal catheter placement with image guidance
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Typical site of service: Hospital outpatient setting, ambulatory surgical center, or interventional radiology suite
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with end-stage renal disease on hemodialysis presents for percutaneous placement and tunneling of a peritoneal dialysis catheter. The procedure is scheduled in an outpatient interventional radiology suite with fluoroscopic and ultrasound guidance. The patient is evaluated pre-procedure by the interventional radiologist and nursing staff for coagulation status, prior abdominal surgeries, and current infections. Under conscious sedation and local anesthesia, ultrasound is used to identify a safe entry site, and fluoroscopy confirms intraperitoneal placement. Contrast instillation may be performed to verify catheter tip position and demonstrate adequate flow. The catheter is tunneled subcutaneously and secured with a cuff. Post-procedure care includes monitoring for peritoneal leak, bleeding, or infection, instructions for catheter care, and coordination with nephrology for initiation of dialysis or with oncology/palliative teams if catheter is placed for intraperitoneal chemotherapy or ascites drainage. Documentation includes indication, imaging guidance used, contrast administration if performed, sedation level, post-procedure findings, and discharge instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician interpretation portion of imaging if separated from technical fee |