Ask Dr. Z

Patient has a history of gallbladder fossa abscess and metastatic gallbladder cancer, order for cholangiogram, drain wash-out, and drain change if indicated. Per OP, abscess beneath right lobe of liver extending to left. A modified biliary drain was replaced into the site of abscess. Site of abscess contained bile, no inflammatory debris. Given the orders & abscess site containing only bile, this seems to be an exchange of biliary cath 47536. Given the mention of abscess, clinic is arguing this should be an exchange of an abscess cath 49423 instead. How would you code the procedure? Please provide rationale.