Coding for peritoneogram and associated injection procedures

Q.

We recently had a physician perform a procedure on a patient which he referred to as a peritoneogram. He injected contrast through a peritoneal dialysis catheter and saw the catheter was kinked. I am considering reporting CPT^® code 49427, and would like your recommendation? 

A.

We recommend reporting CPT codes 49400 and 74190 instead of 49427 as the procedure was performed through a peritoneal dialysis catheter and not a peritoneal venous shunt. The codes and full descriptions are as follows:

49400 Injection of air or contrast into peritoneal cavity (separate procedure)

74190 Peritoneogram (e.g., after injection of air or contrast), radiological supervision and interpretation

49427 Injection procedure (e.g., contrast media) for evaluation of previously placed peritoneal-venous shunt