Forum - Questions & Answers

Dec 30th, 2021 - surgicalcoder65 2 

Drainage Catheter Flush

What CPT code do you use to flush a drainage catheter a few days after a surgery? This drainage catheter was placed in soft tissue of the thigh after an abscess removal. The surgeon wanted to make sure it was functioning fine. TIA.Richard

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Dec 30th, 2021 - ChrisW   247  1 

re: Drainage Catheter Flush

I am unable to find a code for post-surgery drainage, I believe it would be integral to post-service care after a procedure or a part of the post Op office visit.
According to CMS: wound irrigation is integral to the treatment of all wounds and does not have a HCPCS/CPT code, this may or may not fall into that category. Services integral to HCPCS/CPT code-defined procedures are included in those procedures based upon the standards of medical/surgical practice. It is inappropriate to separately report services that are integral to another procedure with that procedure.
There are also other considerations:
Is there a 10-day post-Op global period?
Was it a significant E&M? Would the use of modifier 25 be applicable?
You might consider reporting an unlisted code such as 27899 and include documentation as to why the procedure was done.  The payer will determine if it is payable from your documentation.  When using an unlisted code attach the following documentation according to HMSA:
•             A clear definition or description of the nature, extent, and need for the procedure.•             Indicate why it cannot be addressed with the standard coded CPT procedures.•             An operative report.•             Provide a reasonably comparable service code/procedure, value in comparable RVU,                 and/or percentage of a reasonably comparable CPT.
 
 Hopefully, someone else will have additional knowledge on this and will offer their insight.
Check out the GENERAL CORRECT CODING POLICIES FOR NATIONAL CORRECT CODING INITIATIVE POLICY MANUAL FOR MEDICARE SERVICES, it may help with other situations as well in the future.

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