CPT® Code 49419

The CPT® Code 49419 refers to the procedure involving the insertion of a tunneled intraperitoneal catheter that includes a subcutaneous port, which is also known as a totally implantable port. This type of catheter is designed to remain indwelling, meaning it is placed inside the body and does not have any external access ports, allowing for a more discreet and comfortable option for patients. The primary applications of this catheter include the infusion of chemotherapeutic agents directly into the abdominal cavity and facilitating intraperitoneal dialysis, which is a treatment for kidney failure. The procedure involves making an incision in the upper abdomen, through which the peritoneum is accessed. During the insertion, any adhesions present in the abdominal cavity are carefully lysed, and the bowel is dissected as necessary to create a clear space within the peritoneum, ensuring that the catheter can be placed without obstruction. A subcutaneous pocket is then created for the port, which is sutured to the fascia and filled with heparinized saline to maintain patency. The catheter is tunneled through the subcutaneous tissue to the peritoneal cavity, where it is advanced after puncturing the peritoneum. Finally, the functionality of the port and catheter is verified to ensure that fluids can flow freely into the abdominal cavity, after which the incisions are closed securely.