How To Use CPT Code 47533

CPT 47533 describes the placement of a biliary drainage catheter through the skin using image guidance, such as ultrasound and/or fluoroscopy, for external drainage of bile. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 47533?

CPT 47533 is used to describe the percutaneous placement of a biliary drainage catheter, which allows for external drainage of bile. This procedure is performed by a healthcare provider using image guidance, such as ultrasound and/or fluoroscopy, to ensure accurate placement of the catheter. The catheter is inserted through the skin and advanced into the bile ducts to relieve obstruction and facilitate drainage of bile.

2. Official Description

The official description of CPT code 47533 is: ‘Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate anesthesia and prepping the area of insertion.
2. Using image guidance, such as ultrasound or fluoroscopy, the provider inserts a needle into the liver via a puncture and advances it to the bile duct.
3. A guide wire is then inserted through the needle, and a drainage catheter is advanced over the guide wire into the bile ducts above the obstruction.
4. The guide wire is removed, and the catheter is left in place with the internal end secured in the bile duct.
5. The external end of the catheter is secured with stitches, and a drainage system is attached.
6. A compression bandage is applied at the site of the puncture to ensure proper healing.
7. If necessary, the provider may perform a diagnostic cholangiography by injecting a contrast dye into the bile ducts to visualize the inside of the ducts.

4. Qualifying circumstances

CPT 47533 is performed on patients who require external drainage of bile due to an obstruction in the bile ducts. The procedure is typically indicated for conditions such as gallstones, tumors, or strictures that prevent the normal flow of bile. The patient must be appropriately prepped and anesthetized, and the healthcare provider must use image guidance, such as ultrasound or fluoroscopy, to ensure accurate placement of the catheter.

5. When to use CPT code 47533

CPT code 47533 should be used when a healthcare provider performs the percutaneous placement of a biliary drainage catheter for external drainage of bile. This code includes the use of image guidance, such as ultrasound or fluoroscopy, and any associated radiological supervision and interpretation. It should not be reported with other codes for cholangiography procedures or for the placement of an internal-external drainage catheter.

6. Documentation requirements

To support a claim for CPT 47533, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for external drainage of bile
• Use of image guidance, such as ultrasound or fluoroscopy
• Date and details of the procedure, including the start and end time
• Specific steps taken during the procedure, including the insertion of the catheter and any diagnostic cholangiography performed
• Any complications or additional interventions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 47533, ensure that the procedure meets the criteria outlined in the official description. The code includes imaging guidance and radiological supervision and interpretation, so separate coding for these services is not necessary. However, it should not be reported with other codes for cholangiography procedures or for the placement of an internal-external drainage catheter. Review CPT and payer-specific guidelines for any additional requirements or modifiers that may be necessary for accurate billing.

8. Historical information

CPT 47533 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 patient with gallstones undergoes percutaneous placement of a biliary drainage catheter for external drainage of bile.
2. A healthcare provider performs the procedure on a patient with a bile duct tumor to relieve obstruction and facilitate drainage of bile.
3. A patient with a biliary stricture undergoes the placement of a biliary drainage catheter to alleviate the blockage and allow for external drainage of bile.
4. A healthcare provider performs the procedure on a patient with a postoperative complication, such as a bile leak, to drain excess bile and promote healing.
5. A patient with a history of recurrent gallstone pancreatitis undergoes the placement of a biliary drainage catheter to prevent further episodes.
6. A healthcare provider performs the procedure on a patient with primary sclerosing cholangitis to alleviate symptoms and improve liver function.