How To Use CPT Code 47534

CPT 47534 describes the placement of a biliary drainage catheter through the skin using image guidance, such as ultrasound and/or fluoroscopy. 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 47534?

CPT 47534 is used to describe the percutaneous placement of a biliary drainage catheter, including diagnostic cholangiography when performed, using imaging guidance such as ultrasound and/or fluoroscopy. This procedure allows for both internal and external drainage of bile, a substance produced in the liver and stored in the gallbladder that helps break down food. The provider inserts a catheter through the skin into the bile ducts to facilitate the drainage process.

2. Official Description

The official description of CPT code 47534 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; internal-external.’

3. Procedure

1. The provider prepares the patient for the procedure, ensuring appropriate anesthesia and prepping the area.
2. Using ultrasound or image guidance, 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 and through any obstructions.
4. The guide wire is removed, and the catheter is left in place, with the internal end secured to allow drainage of bile into the duodenum.
5. The external end of the catheter is secured with stitches, and an external drainage system is attached.
6. A compression bandage is applied at the puncture site to ensure proper healing.
7. If necessary, the provider may perform diagnostic cholangiography by injecting a contrast dye into the bile ducts to visualize the internal structures.

4. Qualifying circumstances

CPT 47534 is performed on patients who require internal and external drainage of bile. The procedure is typically indicated for individuals with conditions affecting the biliary tract, such as obstructions or other abnormalities. The provider must use imaging guidance, such as ultrasound and/or fluoroscopy, to ensure accurate placement of the catheter. Additionally, the procedure may involve diagnostic cholangiography, which requires the injection of a contrast dye to visualize the bile ducts.

5. When to use CPT code 47534

CPT code 47534 should be used when a provider performs the percutaneous placement of a biliary drainage catheter, including diagnostic cholangiography when performed, using imaging guidance. This code is appropriate when both internal and external drainage of bile is required. It is important to note that CPT code 47534 should not be reported if the procedure involves the placement of an external drainage catheter, as that would require a different code (47533).

6. Documentation requirements

To support a claim for CPT code 47534, the provider must document the following information:

• Patient’s diagnosis and the need for biliary drainage
• Use of imaging guidance, such as ultrasound and/or fluoroscopy
• Date of the procedure
• Specific details of the procedure, including the placement of the catheter and any diagnostic cholangiography performed
• Any associated radiological supervision and interpretation
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 47534, ensure that the procedure meets the criteria outlined in the official description. The provider should use imaging guidance, such as ultrasound and/or fluoroscopy, and perform any necessary diagnostic cholangiography. It is important to note that the code includes all associated radiological supervision and interpretation, so separate billing for these services is not necessary. Review CPT® and payer-specific guidelines for any additional requirements or considerations when reporting this code.

8. Historical information

CPT code 47534 was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a biliary obstruction undergoes percutaneous placement of a biliary drainage catheter, including diagnostic cholangiography, using ultrasound guidance.
2. A provider performs the percutaneous placement of a biliary drainage catheter, including diagnostic cholangiography, for a patient with a biliary stricture, utilizing fluoroscopy for image guidance.
3. Using both ultrasound and fluoroscopy, a provider places a biliary drainage catheter, including diagnostic cholangiography, in a patient with a biliary stone.
4. A patient with a biliary tumor undergoes percutaneous placement of a biliary drainage catheter, including diagnostic cholangiography, with the assistance of both ultrasound and fluoroscopy.
5. For a patient with a biliary fistula, a provider performs the percutaneous placement of a biliary drainage catheter, including diagnostic cholangiography, using ultrasound guidance.
6. Using fluoroscopy, a provider places a biliary drainage catheter, including diagnostic cholangiography, in a patient with a biliary stricture.
7. A patient with a biliary stone undergoes percutaneous placement of a biliary drainage catheter, including diagnostic cholangiography, with the assistance of both ultrasound and fluoroscopy.