Ask Dr. Z

You have given previous advice to code the psoas muscle image-guided fluid collection to 49406. My research shows that the psoas muscle is not in the retroperitoneal space. Would this still be coded to 49406, and can you please explain why?

"Operative Report: Finally, attention is turned to placement of percutaneous drainage catheter from the left iliopsoas abscess. Under fluoroscopic guidance and utilizing bony landmarks, an 18 gauge Hawkins needle is directed from a posterior percutaneous approach into the abscess collection. Aspiration yields frank pus. A sample is sent to micrology for analysis. Exchange is then made over guidewire after utilization of fascial dilators for a 12 French multi-sidehole pigtail drainage catheter. Appropriate catheter positioning is again confirmed with aspiration of frank pus. The catheter is secured at skin insertion site with non-absorbable suture and placed to accordion drainage."