Ask Dr. Z

A patient with liver mets had a tunneled drainage catheter in place for management of ascites. During the first procedure the catheter was flushed, and peritoneal fluid was aspirated. The catheter was left in place. One week later the paracentesis catheter was studied under ultrasound and fluoroscopic guidance. The catheter was found to be encased in a fibrin sheath. A multipurpose catheter and glidewire were used to clear the side-holes in the drainage catheter. The catheter was flushed, drained, and capped. I'm having trouble finding codes for both these situations in the code series for abscess drainage or ascites. Would code 49021 work for the flush and aspiration in the first case? Do I have to use an unlisted code for the fibrin sheath removal in second procedure? Would codes 49424/76080 be used for the study?