How To Use CPT Code 47420

CPT 47420 describes a procedure involving the incision of the common bile duct to explore, drain, or remove a calculus. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 47420?

CPT 47420 is a code used to describe a procedure in which the provider makes an incision in the common bile duct to explore, drain, or remove a calculus. This procedure may also involve the placement of a tube in the duct to encourage fluid drainage. It is important to note that this code does not include transduodenal sphincterotomy or sphincteroplasty.

2. Official Description

The official description of CPT code 47420 is: ‘Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty.’

3. Procedure

1. During the procedure, the provider makes an incision in the upper abdomen of the patient.
2. The provider then identifies and explores the common bile duct.
3. If a calculus is present, the provider may remove it.
4. In some cases, a tube may be placed in the duct to facilitate drainage of fluid.
5. If necessary, the provider may also incise the gallbladder as part of the procedure.
6. After completing the necessary steps, the provider checks for hemostasis and closes the incision with sutures in layers.

4. Qualifying circumstances

CPT 47420 is typically performed on patients who require exploration, drainage, or removal of a calculus from the common bile duct. The procedure may be necessary for conditions such as gallstones or other obstructions in the duct. It is important to note that this code does not include transduodenal sphincterotomy or sphincteroplasty.

5. When to use CPT code 47420

CPT code 47420 should be used when the provider performs a choledochotomy or choledochostomy procedure without transduodenal sphincterotomy or sphincteroplasty. If the provider also performs transduodenal sphincterotomy or sphincteroplasty, a different code should be used. It is important to accurately document the specific procedures performed to ensure proper coding.

6. Documentation requirements

To support a claim for CPT 47420, the provider must document the following information:

• The need for the procedure, including the presence of a calculus or other obstruction in the common bile duct
• Details of the procedure performed, including any exploration, drainage, or removal of a calculus
• Any additional procedures performed, such as cholecystotomy
• Date of the procedure
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 47420, it is important to ensure that the procedure performed aligns with the code description. This code should not be reported if transduodenal sphincterotomy or sphincteroplasty is performed. It is also important to accurately document the specific procedures performed to support the claim. If additional procedures are performed, such as cholecystotomy, a different code may be appropriate.

8. Historical information

CPT code 47420 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. It is important to consult the most recent coding guidelines and updates to ensure accurate reporting.

9. Examples

1. A provider performs a choledochotomy to remove a calculus from the common bile duct.
2. During a procedure, the provider explores the common bile duct and places a tube for drainage.
3. A patient undergoes a choledochostomy to drain fluid from the common bile duct.
4. A provider performs a choledochotomy to explore the common bile duct and removes a calculus.
5. During a procedure, the provider incises the gallbladder and explores the common bile duct to remove a calculus.
6. A patient undergoes a choledochostomy to drain fluid from the common bile duct and explores the duct for any obstructions.
7. A provider performs a choledochotomy to remove a calculus and places a tube in the common bile duct for drainage.
8. During a procedure, the provider explores the common bile duct and removes a calculus without incising the gallbladder.
9. A patient undergoes a choledochostomy to drain fluid from the common bile duct and explores the duct for any obstructions.
10. A provider performs a choledochotomy to remove a calculus and explores the common bile duct for any additional obstructions.