CPT® Code 49203

Deleted

Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less

The procedure described by CPT® Code 49203 involves the open excision or destruction of intra-abdominal tumors, cysts, or endometriomas. This surgical intervention is applicable to one or more tumors located in the peritoneal, mesenteric, or retroperitoneal areas. The tumors addressed in this procedure can vary in nature; they may be benign, such as endometriomas or benign cystic mesotheliomas, or malignant, including adenocarcinomas, malignant mesotheliomas, desmoplastic small cell tumors, or liposarcomas. The procedure allows for the complete excision of these tumors or their destruction through methods such as electrocautery or laser ablation, which is also referred to as surgical ablation. The surgical approach begins with an incision in the abdomen, allowing access to the peritoneum, which is then carefully incised to avoid damaging surrounding organs, including the bowel. Once the peritoneal cavity is opened, any adhesions are dissected to expose the abdominal viscera. A thorough exploration of the abdominal cavity is conducted, both visually and through palpation, to identify all masses and abnormalities. The size, location, and extent of the largest tumor, which must be 5 cm in diameter or less for this code to apply, are documented. The excision or destruction of the tumor is performed, and this process is repeated for any additional tumors present. For retroperitoneal tumors, similar techniques are employed, with particular attention paid to protecting the kidneys, ureters, and renal vessels during the procedure. It is important to note that different CPT codes are designated for tumors of varying sizes, with 49204 applicable for tumors measuring 5.1 to 10.0 cm and 49205 for those exceeding 10.0 cm in diameter.