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separate abscess drains with separate procedures

Date: May 16, 2023

Question:

I have a case where the patient has two abscess drains. One is left flank into abdomen. The other is left transgluteal into pelvis. Separate abscess collections. For the left flank drain, they do an absessogram and then an exchange (49423, 75984). The left transgluteal drain, they do an abscessogram and then, based on that, decide to remove the drain (49424, 76080). Normally, it's the same drain and abscess and we code 49423/75984 only, due to the separate procedure rule. However, in this case, do you think it's an exception to the rule and we should code these four CPTs together due to separate procedures, drainage catheters and fluid collections? Thanks for your expertise.

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