I guess I answered my own question, so if anyone is interested here it goes!
Paracentesis is described in CPT by 49080, peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or therapeutic); initial. This code should be reported for percutaneous drainage of a fluid collection anywhere in the peritoneal space. Paracentesis can be performed in much the same way as thoracentesis, with drainage via needle or cannula. CPT also lists 49081, peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or therapeutic); subsequent, which would describe an additional paracentesis procedure, separately performed with separate access, on the same patient, on the same date. Paracentesis performed on the same patient, but on different dates, would be reported with 49080 on each date of service. The appropriate modality-specific image-guidance code should be reported with 49080 and 49081, unless a catheter is left in place for follow-up paracentesis, which would then be described by 75989. Follow-up paracentesis through a previously placed catheter would be reported with an evaluation and management code, since the catheter placement has already been coded. Report code 49080 only if a new catheter is placed through a new access, on a different date of service, and 49081 only if a new catheter is placed through a new access, on the same date of service as a previous procedure reported with 49080.
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