CPT® Code 49421

The CPT® Code 49421 refers to the procedure of inserting a tunneled intraperitoneal catheter for dialysis through an open surgical technique. This procedure involves creating an incision in the upper abdomen, which allows access to the peritoneal cavity. The term "tunneled" indicates that the catheter is designed to remain in place for an extended period, providing a means for dialysis without the need for repeated access. During the insertion, the surgeon may encounter adhesions, which are bands of scar tissue that can obstruct the surgical field. These adhesions are carefully lysed, and the bowel may be dissected to ensure that the catheter can be placed in a cavity that is free from obstruction. Once the catheter is inserted, it is either clamped or connected to an external port, facilitating the dialysis process. After the catheter is secured, the incision in the upper abdomen is closed, completing the procedure. This method is essential for patients requiring long-term dialysis, as it allows for effective treatment while minimizing the risk of complications associated with temporary access methods.