CPT® Code 49205

Deleted

Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter

The procedure described by CPT® Code 49205 involves the open excision or destruction of intra-abdominal tumors, cysts, or endometriomas. This procedure is applicable to one or more tumors located in the peritoneal, mesenteric, or retroperitoneal areas. The tumors addressed can vary in nature, being either benign, such as endometriomas or benign cystic mesotheliomas, or malignant, including adenocarcinomas, malignant mesotheliomas, desmoplastic small cell tumors, or liposarcomas. The distinction between primary and secondary tumors is also significant, as both types may be encountered during the procedure. During the operation, the surgeon makes an incision in the abdomen to access the peritoneum, which is then carefully incised to prevent damage to surrounding organs, including the bowel. Once the peritoneal cavity is opened, any adhesions are meticulously dissected to expose the abdominal viscera. A thorough exploration of the abdominal cavity is conducted, allowing the surgeon to visually and palpate all masses and abnormalities present. The size, location, and extent of the largest tumor, which must exceed 10.0 cm in diameter for this code to be applicable, are documented. The surgical approach may involve complete excision of the tumor or its destruction through methods such as electrocautery or laser ablation. This process is repeated for each tumor until all have been adequately addressed. For tumors located in the retroperitoneal space, similar techniques are employed, with careful attention to avoid injury to critical structures such as the kidneys, ureters, and renal vessels. The use of CPT® Codes 49203 and 49204 is specified for tumors of smaller sizes, with 49203 designated for tumors 5.0 cm or less and 49204 for those measuring between 5.1 and 10.0 cm in diameter.