How To Use CPT Code 0397T

CPT 0397T describes the use of endoscopic retrograde cholangiopancreatography (ERCP) with optical endomicroscopy. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0397T?

CPT 0397T can be used to describe the use of endoscopic retrograde cholangiopancreatography (ERCP) with optical endomicroscopy. This code is used when a provider performs optical endomicroscopy to obtain high-resolution imaging during the evaluation of the biliary tract. The procedure allows for greatly magnified, pathology-quality images of the gallbladder, pancreas, and bile ducts.

2. Official Description

The official description of CPT code 0397T is: ‘Endoscopic retrograde cholangiopancreatography (ERCP), with optical endomicroscopy (List separately in addition to code for primary procedure).’ It is important to note that this code should be used in conjunction with the appropriate primary procedure codes for ERCP (43260-43278). Additionally, optical endomicroscopy should not be reported more than once per session, and it should not be reported in conjunction with code 88375.

3. Procedure

1. During the same session in which the patient undergoes endoscopic evaluation of the biliary tract, the provider performs optical endomicroscopy to obtain high-resolution imaging.
2. The patient is anesthetized, and the provider inserts a scope through the mouth and down into the duodenum, the first portion of the small intestine, and then the biliary tract ducts.
3. A retrograde injection of dye or contrast material is delivered into the pancreatic and biliary ducts through a catheter inserted through the scope. This allows the provider to obtain X-ray images.
4. The provider uses a flexible fiberoptic endomicroscopy system to obtain additional high-resolution images from thin sections of the tissue.
5. Once the procedure is completed, the scope and all instrumentation are removed.

4. Qualifying circumstances

CPT 0397T is used when a provider performs optical endomicroscopy during the evaluation of the biliary tract. This procedure is typically performed on patients who require further imaging or evaluation of the gallbladder, pancreas, or bile ducts. It is important to note that optical endomicroscopy is an additional procedure that is performed in conjunction with the primary ERCP procedure.

5. When to use CPT code 0397T

CPT code 0397T should be used when a provider performs optical endomicroscopy during the evaluation of the biliary tract. It is important to ensure that the primary ERCP procedure codes (43260-43278) are also reported in conjunction with CPT 0397T. Additionally, optical endomicroscopy should not be reported more than once per session, and it should not be reported in conjunction with code 88375.

6. Documentation requirements

To support a claim for CPT 0397T, the provider must document the following information:

• Indication for the use of optical endomicroscopy during the evaluation of the biliary tract
• Date and time of the procedure
• Details of the primary ERCP procedure performed
• Specific findings or images obtained through optical endomicroscopy
• Any additional relevant information or findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 0397T, ensure that the procedure is performed in conjunction with the appropriate primary ERCP procedure codes (43260-43278). It is important to note that optical endomicroscopy should not be reported more than once per session and should not be reported in conjunction with code 88375. Additionally, it is recommended to check with Medicare or other payers to determine their coverage policies for optical endomicroscopy.

8. Historical information

CPT 0397T was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A gastroenterologist performing optical endomicroscopy during an ERCP procedure to obtain high-resolution images of the gallbladder.
2. A surgeon using optical endomicroscopy to evaluate the pancreas during an ERCP procedure.
3. An interventional radiologist performing optical endomicroscopy to assess the bile ducts during an ERCP procedure.
4. A hepatologist utilizing optical endomicroscopy to obtain detailed images of the biliary tract during an ERCP procedure.
5. An endoscopist performing optical endomicroscopy to evaluate the pancreatic ducts during an ERCP procedure.
6. A gastroenterologist using optical endomicroscopy to assess the gallbladder and bile ducts during an ERCP procedure.
7. A surgeon performing optical endomicroscopy to obtain high-resolution images of the pancreas during an ERCP procedure.
8. An interventional radiologist utilizing optical endomicroscopy to evaluate the biliary tract during an ERCP procedure.
9. A hepatologist performing optical endomicroscopy to assess the bile ducts during an ERCP procedure.
10. An endoscopist using optical endomicroscopy to obtain detailed images of the gallbladder during an ERCP procedure.