How To Use CPT Code 47400

CPT 47400 describes a procedure involving the hepatic duct, which may include exploration, drainage, or removal of calculus. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 47400?

CPT 47400 is used to describe a surgical procedure that involves the hepatic duct. This procedure may include exploration, drainage, or removal of calculus. It is important to note that calculus refers to a stone that can occur in any organ of the body, commonly found in the urinary tract. The provider makes an incision in the upper abdomen, identifies and creates an opening in the hepatic duct, explores the duct, and may remove any stones or place a tube for drainage. The incision is then closed with sutures in layers.

2. Official Description

The official description of CPT code 47400 is: ‘Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision in the upper abdomen.
3. An incision or opening is created in the hepatic duct.
4. The provider explores the hepatic duct and may remove any stones or place a tube for drainage.
5. If a tube is placed, it may be pulled through the skin for drainage.
6. The provider checks for hemostasis and closes the incision with sutures in layers.

4. Qualifying circumstances

CPT 47400 is performed when there is a need for exploration, drainage, or removal of calculus in the hepatic duct. The procedure is typically performed on patients who have stones or other conditions affecting the hepatic duct. It is important to note that the hepatic duct is a tube that extends from the liver, allowing for the transfer of bile to the common bile duct and then the small intestine.

5. When to use CPT code 47400

CPT code 47400 should be used when a provider performs a hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus in the hepatic duct. It is important to ensure that the procedure performed aligns with the official description of the code.

6. Documentation requirements

To support a claim for CPT 47400, the provider must document the following information:

• Patient’s diagnosis and the need for the procedure
• Details of the procedure performed, including exploration, drainage, or removal of calculus
• Date of the procedure
• Incision location and size
• Details of any stones or other findings in the hepatic duct
• Details of any tubes placed for drainage
• Details of the closure of the incision
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 47400, ensure that the procedure performed aligns with the official description of the code. It is important to follow the specific guidelines provided by the payer and to accurately document the procedure in the medical record. It is also important to be aware of any additional codes that may need to be reported in conjunction with CPT 47400, depending on the specific circumstances of the procedure.

8. Historical information

CPT 47400 was added to the Current Procedural Terminology system on January 1, 1990. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient undergoes a hepaticotomy with exploration and removal of calculus in the hepatic duct.
2. A provider performs a hepaticostomy with drainage of fluid from the hepatic duct.
3. A patient with stones in the hepatic duct undergoes a hepaticotomy with exploration and placement of a drainage tube.
4. A provider performs a hepaticostomy with exploration and removal of calculus in the hepatic duct.
5. A patient undergoes a hepaticotomy with exploration and removal of a large calculus in the hepatic duct.
6. A provider performs a hepaticostomy with exploration and removal of multiple small calculi in the hepatic duct.
7. A patient with a complex case of calculus in the hepatic duct undergoes a hepaticotomy with exploration and placement of multiple drainage tubes.
8. A provider performs a hepaticostomy with exploration and removal of a large calculus, followed by closure of the incision.
9. A patient undergoes a hepaticotomy with exploration and removal of a stone, with subsequent closure of the incision.
10. A provider performs a hepaticostomy with exploration and removal of multiple small calculi, followed by closure of the incision.