Summary & Overview
CPT 49900: Resuturing Abdominal Incision for Wound Dehiscence
CPT code 49900 covers the operative resuturing of an abdominal incision that has dehisced, ruptured, or allowed evisceration of internal organs. Nationally, this code represents urgent or emergent surgical management of wound failure after abdominal operations and is clinically significant for acute surgical care pathways, hospital resource allocation, and post-operative complication reporting. Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for use of 49900, common service settings, and what typical claims for this procedure reflect about care intensity. The publication summarizes benchmark considerations for payers listed above, notes common billing modifiers and related administrative issues (where provided), and highlights clinical factors that drive utilization and cost in national practice. Data not available in the input is identified explicitly where applicable. This summary is intended for health policy analysts, hospital billing managers, and clinical leaders seeking a concise reference on the purpose and national relevance of CPT code 49900.
Billing Code Overview
CPT code 49900 describes the resuturing of an abdominal surgical incision after wound dehiscence, rupture, or evisceration with protrusion of internal organs. This procedure involves surgical reapproximation of the abdominal wall and closure of the fascial and skin layers to manage a compromised or open laparotomy incision.
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Service type: Surgical wound management / abdominal reclosure
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Typical site of service: Operating room or other surgical suite where operative abdominal procedures are performed
Data not available in the input for payerspecific coverage, associated taxonomies, and ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old postoperative patient who returns to the emergency department with acute abdominal wound dehiscence after an open exploratory laparotomy performed 7 days earlier for bowel obstruction. The patient reports serosanguinous drainage from the incision, increased pain, and visible separation of the incision edges, with possible protrusion of bowel. On exam there is partial evisceration of small bowel through the midline incision. The clinical workflow begins with emergency stabilization, wound assessment, broad-spectrum antibiotics as indicated, and imaging if needed to evaluate intra-abdominal involvement. The surgical team prepares for urgent return to the operating room for wound exploration and formal resuturing of the dehisced abdominal incision under anesthesia. Intraoperative steps include assessment for contamination or necrotic tissue, irrigation, reduction of eviscerated contents, possible revision of fascial closure, layered soft-tissue closure, and appropriate drains if indicated. Postoperative management includes monitoring for infection, wound care, pain control, and discharge planning with outpatient wound follow-up. Typical site of service is the hospital operating room (inpatient or emergency surgical setting). The service type is urgent/emergent open surgical wound repair for abdominal wound dehiscence with or without evisceration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work required is substantially greater than usual for this procedure (e.g., extensive debridement, dense adhesions, contaminated field). |