I have a question for anyone who has already tried billing this code for open intraperitoneal catheter placement. Usually our docs come in and help the spine guys with the placement and or revision of a (CSF) Shunt via laparoscope, according to our docs they do the abdominal portion and then the spine guys come in and do their portion cerebrally tunneling down until they reach our docs incision and then our doc places the catheter into the abdominal cavity. Well laparoscopically it is cut and dry code 49324, but when they do it open code 49324 in CPT says to refer to code 49421 which has a definition of insertion of catheter for dialysis, open. Why would CPT refer you to this code if it is for dialysis when clearly that is not what we are doing it for? Why would it not refer us to code 49418? Since CPT is referring us to code 49421 would the description in CPT cause conflict with the insurance carriers?