Ask Dr. Z

In the case where the existing drain was exchanged, and a second one was placed into the same abscess collection, would you code 49406, or 49423/75984, or both? It appears to be over the same access, just angled into a different area of the same collection.

"Under fluoroscopic guidance, the indwelling abscess drain was injected with contrast. Next, a Glidewire was advanced through the indwelling drain was removed. A 5 French sheath was then placed. Alongside the Glidewire a second wire was advanced and directed upward within the intra-abdominal abscess. The sheath was removed. A new 12 French biliary style abscess drain was placed in the inferior pocket. A new 10.2 French biliary style abscess drain was placed in the inferior aspect of the intra-abdominal abscess. Both drains were secured to the skin silk suture and a sterile dressing was applied"