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Thread: Help with peritoneal port and chest port

  1. #1
    Join Date
    Apr 2007
    Dallas, GA

    Default Help with peritoneal port and chest port

    AAPC: Back to School
    INDICATION: Malfunction of peritoneal port, pain with chemotherapy
    administration and CT findings of possible occlusion of peritoneal port
    distal aspect.

    After written informed consent was obtained and under sterile
    conditions, after administration of local anesthetic, the peritoneal
    port was accessed under fluoroscopic guidance with a 19-gauge Huber
    needle. Contrast was administered. With hand-injection of contrast,
    there was filling of the peritoneal space outlining loops of bowel
    within the left lower quadrant, tracking laterally and superiorly with
    time, and a volume of 40 mL being administered of diluted contrast and
    saline. There was minimal backtracking of contrast along the sidewall of
    the port seen to occur with moderate forceful injection. With slow
    injection, there was dispersion of the contrast throughout the
    peritoneal cavity which over time out to 10 minutes dispersed normally
    without persistence of contrast at the catheter tip. The entirety of
    the catheter lumen is patent.

    Catheter was then loaded with 100 units/mL of heparin.

    After discussion with infusion nurse, I was asked also to confirm
    patency and function of chest port. Fluoroscopic evaluation revealed no
    evidence of kinking in the tip of the port overlying the SVC just
    proximal to the right atrium in good location. The left chest port was
    accessed under sterile conditions after administration of local
    anesthetic with a 19-gauge Huber needle. Contrast was administered
    demonstrating patency of the port lumen and rapid flow into the SVC
    without hindrance. There is no evidence of fibrin sheath. Blood could be
    aspirated from the port repeatedly. The port was then loaded with 100
    units/mL heparin and Huber needle withdrawn. The patient tolerated the
    procedure well.

    The patient did receive IV Versed and fentanyl given intravenously for a
    total of 30 minutes.


    Peritoneal port is functional with normal dispersion of injected
    material throughout the peritoneum, demonstrated without evidence of
    seroma at the tip of the catheter nor blockage of the catheter.
    Administration of chemotherapy via gravity should work well.

    Left chest port in place and functional without evidence of
    complication. Blood could be aspirated. Catheter tip is in good

    I have looked at codes 49427 and 78291 but this does not say anything about being venous related and I have also looked at 49424 and 76080 but this was not done to evalute abscess or cyct.... can anyone offer any help?

  2. #2
    Join Date
    Apr 2007


    peritoneal catheter injection-49424,76080
    port injection-36598

  3. #3
    Join Date
    Apr 2007
    Dallas, GA


    Quote Originally Posted by Rajebpt View Post
    peritoneal catheter injection-49424,76080
    port injection-36598
    Do you think 49424 and 76080 is still appropriate even though it was not done to evalute an abscess or cyct?

    I can't find much guidance for these codes other than what is printed in the CPT book.

    Christy, CPC

  4. #4
    Join Date
    Apr 2007


    We dont have any other codes for peritoneal injection.I used to code the same

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