Summary & Overview
CPT 49419: Intraperitoneal Catheter with Subcutaneous Reservoir Implantation
CPT code 49419 denotes surgical implantation of a tunneled intraperitoneal catheter combined with creation of a subcutaneous pocket to house a pump or drug reservoir for delivery of chemotherapy or other agents into the abdominal cavity. This procedure establishes a durable delivery system for regional therapy such as intraperitoneal chemotherapy, insulin, or analgesics and has implications for care pathways, device management, and reimbursement across inpatient and ambulatory surgical settings.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and coding practices for implanted intraperitoneal drug delivery systems vary by payer and by site of service, affecting prior authorization, bundling, and facility payment considerations.
Readers will find an overview of the clinical purpose and procedural elements of the service, the typical settings where it is performed, and the list of common modifiers associated with billing for this procedure. The publication also summarizes payer coverage presence and notes where input data is unavailable. The content is intended to inform clinicians, billing professionals, and policy analysts about the coding context, operational considerations, and where to expect variability in payer handling of CPT code 49419.
Billing Code Overview
CPT code 49419 describes the surgical insertion of a tunneled intraperitoneal catheter with creation of a subcutaneous pocket in the rectus fascia to house a pump or reservoir for delivery of a drug or therapeutic agent. The tunneled catheter delivers medication from the subcutaneous reservoir into the abdominal (peritoneal) cavity.
Service type: Surgical implantation of intraperitoneal drug delivery system
Typical site of service: Operating room or ambulatory surgical center, with post‑operative management in an inpatient or outpatient setting as clinically indicated.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with advanced ovarian carcinoma requires placement of an intraperitoneal tunneled catheter and subcutaneous pump reservoir to deliver regional chemotherapy. The patient presents to the operating room after preoperative assessment and informed consent. Under general anesthesia, the surgeon creates a small abdominal incision, tunnels a catheter into the peritoneal cavity, fashions a subcutaneous pocket in the rectus fascia, and implants a pump/reservoir. The catheter is secured and tested for patency, and the pocket is closed. Postoperative workflow includes immediate recovery monitoring for hemodynamic stability, assessment of catheter function and wound integrity, pain control, and instruction for oncology nursing on pump access and drug administration. Typical site of service is an operating room in an ambulatory surgery center or hospital inpatient surgical suite depending on patient comorbidities and planned chemotherapy schedule. Typical service type is a surgical implant of a tunneled intraperitoneal catheter with placement of a subcutaneous drug reservoir (implantable pump).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (standard reporting) | Use when no special circumstances apply and the procedure is billed as performed. |
11 |