Exchange of biliary drainage catheter (eg,

47536

Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation

47537

Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation

There was previously no code for removal of a biliary drainage catheter. "There is no code for removal of an external or internal-external biliary catheter. For physician billing, the catheter removal is included in the insertion when the catheter is removed during the 90-day global period. For hospital billing, it may be appropriate to report a low-level clinic visit code for the encounter during which the tube is removed, depending upon the hospital's visit classification criteria." [AHIMA]

47538

Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation, each stent; existing access

47539

Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter

47540

Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)

47541

Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access

47542

Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (List separately in addition to code for primary procedure)

47543

Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (List separately in addition to code for primary procedure)

47544

Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)

49185

Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed

2015 Code Descriptor

2016

Change Crosswalk Code

Descriptor Advice

47136

Liver allotransplantation; heterotopic, partial or whole, from cadaver or living donor, any age

Deleted

(47136 has been deleted. To report, use 47399)

The 2016 code set deleted 47136 for a heterotopic liver allotransplantation. CPT? removed this code as the practice of performing an allotransplantation, that is an organ or tissue transfer between genetically different individuals of the same species, using a heterotopic graft, or the placement of a liver graft into another anatomical location, is rarely done due to the history of poor outcomes. The procedure is most commonly done through an orthotopic graft placement, meaning the placement of a liver graft in the same anatomic location.

If a heterotopic liver allotransplantation is performed, CPT? advises to use 47399Unlisted procedure, liver; to report this service. Remember to send supporting documentation to payers with any claim containing an unlisted code. Keep in mind that CPT? does not recommend the use of unlisted procedures on a regular basis.

47500

Injection procedure for percutaneous transhepatic cholangiography

Deleted

(47500, 47505, 47510, 47511, 47525, 47530 have been deleted. To report, see 47531-47541)

The 2016 code set deleted 47500 for the injection portion of a percutaneous transhepatic cholangiography. CPT? deleted this code along with other percutaneous biliary procedures as part of the percutaneous biliary procedures bundling. The corresponding radiology supervision and interpretation, or SI codes, such as 74320-Cholangiography, percutaneous, transhepatic, radiological supervision and interpretation, reportable with this code were also deleted.

CPT? then added the bundled services that describe percutaneous biliary procedures including the radiologic imaging in a new range 47531 to 47541. To report this service, CPT? advises to select an appropriate code from this new range that includes the diagnostic cholangiography when performed, imaging guidance, and all associated radiological supervision and interpretation.

In 2016, CPT? 47531 represents the injection procedure for a complete diagnostic percutaneous cholangiography, including imaging guidance such as ultrasound and/or fluoroscopy and all the associated radiological supervision and interpretation; done through an existing access. Code 47532 is for a new access such as a percutaneous transhepatic cholangiogram. Code 47533 is for the percutaneous placement of an external biliary drainage catheter and 47534 is for an internal-external catheter. 47535 is for the conversion of an external biliary drainage catheter to an internal-external biliary drainage catheter, 47536 for the exchange of a biliary drainage catheter, and 47537 for its removal. 47538 is for the percutaneous placement of a stent or stents into a bile duct through an existing access and 47539 if through a new access without placement of separate biliary drainage catheter, while 47540 is for a new access placement with a separate biliary drainage catheter. Finally, 47541 is for a new access placement through the biliary tree and into small bowel to assist with an endoscopic biliary procedure.

47505

Injection procedure for cholangiography through an existing catheter (eg, percutaneous transhepatic or Ttube)

Deleted

(47500, 47505, 47510, 47511, 47525, 47530 have been deleted. To report, see 47531-47541)

The 2016 code set deleted 47505 for the injection procedure for a cholangiogram done through and existing catheter. CPT? deleted this code along with other percutaneous biliary procedures as part of the percutaneous biliary procedures bundling. The corresponding radiology supervision and interpretation, or SI codes, such as 74305-Cholangiography and/or pancreatography; through existing catheter, radiological supervision and interpretation, reportable with this code were also deleted.

CPT? then added the bundled services that describe percutaneous biliary procedures including the radiologic imaging in a new range 47531 to 47541. To report this service, CPT? advises to select an appropriate code from this new range that includes the diagnostic cholangiography when performed, imaging guidance, and all associated radiological supervision and interpretation.

In 2016, CPT? 47531 represents the injection procedure for a complete diagnostic percutaneous cholangiography, including imaging guidance such as ultrasound and/or fluoroscopy and all the associated radiological supervision and interpretation; done through an existing access. Code 47532 is for a new access such as a percutaneous transhepatic cholangiogram. Code 47533 is for the percutaneous placement of an external biliary drainage catheter, and 47534 is for an internal-external catheter. 47535 is for the conversion of an external biliary drainage catheter to an internal-external biliary drainage catheter, 47536 for the exchange of a biliary drainage catheter, and 47537 for its removal. 47538 is for the percutaneous placement of a stent or stents into a bile duct through an existing access and 47539 if through a new access without placement of separate biliary drainage catheter, while 47540 is for a new access placement with a separate biliary drainage catheter. Finally, 47541 is for a new access placement through the biliary tree and into small bowel to assist with an endoscopic biliary procedure.

47510

Introduction of percutaneous transhepatic catheter for biliary drainage

Deleted

(47500, 47505, 47510, 47511, 47525, 47530 have been deleted. To report, see 47531-47541)

47511 Introduction of percutaneous transhepatic stent

Deleted (47500, 47505, 47510, 47511, 47525, 47530

The 2016 code set deleted 47510 for the introduction of a percutaneous transhepatic catheter for biliary drainage. CPT? deleted this code along with other percutaneous biliary procedures as part of the percutaneous biliary procedures bundling. The corresponding radiology supervision and interpretation, or SI codes, such as 75980- Percutaneous transhepatic biliary drainage with contrast monitoring, radiological supervision and interpretation, reportable with this code were also deleted.

CPT? then added the bundled services that describe percutaneous biliary procedures including the radiologic imaging in a new range 47531 to 47541. To report this service, CPT? advises to select an appropriate code from this new range that includes the diagnostic cholangiography when performed, imaging guidance, and all associated radiological supervision and interpretation.

In 2016, CPT? 47531 represents the injection procedure for a complete diagnostic percutaneous cholangiography, including imaging guidance such as ultrasound and/or fluoroscopy and all the associated radiological supervision and interpretation; done through an existing access. Code 47532 is for a new access such as a percutaneous transhepatic cholangiogram. Code 47533 is for the percutaneous placement of an external biliary drainage catheter, and 47534 is for an internal-external catheter. 47535 is for the conversion of an external biliary drainage catheter to an internal-external biliary drainage catheter, 47536 for the exchange of a biliary drainage catheter, and 47537 for its removal. 47538 is for the percutaneous placement of a stent or stents into a bile duct through an existing access and 47539 if through a new access without placement of separate biliary drainage catheter, while 47540 is for a new access placement with a separate biliary drainage catheter. Finally, 47541 is for a new access placement through the biliary tree and into small bowel to assist with an endoscopic biliary procedure.

The 2016 code set deleted 47511 for the introduction of a percutaneous

transhepatic stent for internal and external biliary drainage

47525, 47530 have been deleted. To report, see 47531-47541)

transhepatic stent for internal or external biliary drainage. CPT? deleted this code along with other percutaneous biliary procedures as part of the percutaneous biliary procedures bundling. The corresponding radiology supervision and interpretation, or SI codes, such as 75982-Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients with an inoperable mechanical biliary obstruction, radiological supervision and interpretation, reportable with this code were also deleted.

CPT? then added the bundled services that describe percutaneous biliary procedures including the radiologic imaging in a new range 47531 to 47541. To report this service, CPT? advises to select an appropriate code from this new range that includes the diagnostic cholangiography when performed, imaging guidance, and all associated radiological supervision and interpretation.

In 2016, CPT? 47531 represents the injection procedure for a complete diagnostic percutaneous cholangiography, including imaging guidance such as ultrasound and/or fluoroscopy and all the associated radiological supervision and interpretation; done through an existing access. Code 47532 is for a new access such as a percutaneous transhepatic cholangiogram. Code 47533 is for the percutaneous placement of an external biliary drainage catheter, and 47534 is for an internal-external catheter. 47535 is for the conversion of an external biliary drainage catheter to an internal-external biliary drainage catheter, 47536 for the exchange of a biliary drainage catheter, and 47537 for its removal. 47538 is for the percutaneous placement of a stent or stents into a bile duct through an existing access and 47539 if through a new access without placement of separate biliary drainage catheter, while 47540 is for a new access placement with a separate biliary drainage catheter. Finally, 47541 is for a new access placement through the biliary tree and into small bowel to assist with an endoscopic biliary procedure.

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