CPT® Code 49427

The CPT® Code 49427 refers to an injection procedure specifically designed for the evaluation of a previously placed peritoneal-venous shunt. A peritoneal-venous shunt is a medical device utilized primarily in the management of ascites, which is characterized by the abnormal accumulation of fluid within the peritoneal cavity. This procedure involves the administration of a local anesthetic to the peritoneal cavity, ensuring patient comfort during the injection process. Following this, a contrast media or a radiotracer, such as technetium-99m sulfur colloid (TC99m-SC) or technetium-99m macroaggregated albumin (TC99m-MAA), is injected into the left lower quadrant of the abdomen. The choice of radiotracer is crucial for visualizing the flow and function of the shunt. In cases where a LeVeen shunt is present, the abdomen is gently massaged to facilitate the distribution of the radiotracer throughout the peritoneal cavity. Conversely, for patients with a Denver shunt, they are instructed to actively pump the system to ensure proper flow. After the injection procedure, it is essential to obtain radiographs, which are separately reportable, to assess the patency of the peritoneal-venous shunt, thereby confirming its functionality and effectiveness in managing the patient's condition.