How To Use CPT Code 47425

CPT 47425 describes a specific procedure involving the biliary tract. This article will provide an overview of CPT code 47425, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 47425?

CPT 47425 is a code that represents a particular procedure performed on the biliary tract. It involves the identification and incision of the common bile duct, with various potential actions such as exploration, drainage, or removal of calculus. Additionally, the procedure may include a transduodenal sphincterotomy or sphincteroplasty, which involves incising the sphincter of Oddi where the duct enters the small intestine.

2. Official Description

The official description of CPT code 47425 is: ‘Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty.’

3. Procedure

1. During the procedure, the healthcare provider makes an incision in the upper abdomen after appropriately prepping and anesthetizing the patient.
2. The provider then identifies and explores the common bile duct, examining its structure and potentially removing any stones present.
3. If necessary, the provider may place a tube in the duct to facilitate the drainage of fluid.
4. In some cases, the provider may also choose to incise the gallbladder as part of the procedure.
5. Following these steps, the provider performs a transduodenal sphincterotomy or sphincteroplasty. This involves incising the duodenum to access and incise the sphincter of Oddi, which can help improve the drainage of fluids in the bile duct or remove stones.
6. After ensuring hemostasis, the provider closes the incision in the abdomen with sutures in layers.

4. Qualifying circumstances

CPT code 47425 is used when the provider performs a choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy. Additionally, the procedure may involve a transduodenal sphincterotomy or sphincteroplasty. It is important to note that this code should only be used when these specific actions are performed.

5. When to use CPT code 47425

CPT code 47425 should be used when the provider performs the described procedure involving the biliary tract. It is important to ensure that the actions specified in the code’s official description are carried out during the procedure. If the provider does not perform the transduodenal sphincterotomy or sphincteroplasty, a different code should be used.

6. Documentation requirements

When documenting a claim for CPT code 47425, the healthcare provider should include the following information:

• Patient’s diagnosis and the need for the procedure
• Details of the procedure performed, including exploration, drainage, or removal of calculus, and whether cholecystotomy was performed
• Documentation of the transduodenal sphincterotomy or sphincteroplasty, if applicable
• Date of the procedure
• Any additional relevant information or findings
• Provider’s signature

7. Billing guidelines

When billing for CPT code 47425, it is important to ensure that the procedure meets the criteria outlined in the code’s official description. Additionally, consider the following guidelines:

• Do not report CPT code 47425 if the provider does not perform the transduodenal sphincterotomy or sphincteroplasty.
• If the provider incises the gallbladder without incising the common bile duct, a separate code should be used.
• If the provider performs the transduodenal sphincterotomy or sphincteroplasty as a separate procedure, a different code should be reported.

8. Historical information

CPT code 47425 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. It is worth noting that Medicare added this procedure to the Inpatient Only (IPO) list in 2017.

9. Examples

1. A healthcare provider performs a choledochotomy with exploration and removal of calculus, along with a transduodenal sphincterotomy, to address a patient’s biliary stone disease.
2. During a procedure, a provider performs a choledochostomy with drainage of fluid and a transduodenal sphincteroplasty to improve the drainage of fluids in a patient’s common bile duct.
3. A patient undergoes a choledochotomy with exploration and removal of calculus, along with a transduodenal sphincterotomy, to address complications related to their biliary tract.
4. A provider performs a choledochostomy with exploration and removal of calculus, along with a transduodenal sphincteroplasty, to address a patient’s biliary obstruction.
5. During a procedure, a provider performs a choledochotomy with drainage of fluid and a transduodenal sphincterotomy to address a patient’s biliary stricture.
6. A patient undergoes a choledochostomy with exploration and removal of calculus, along with a transduodenal sphincteroplasty, to address complications related to their biliary tract.