How To Use CPT Code 47539

CPT 47539 describes the placement of stent(s) into a bile duct through a new percutaneous access route, without the placement of a separate biliary drainage catheter. 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 47539?

CPT 47539 can be used to describe the placement of stent(s) into a bile duct through a new percutaneous access route, without the placement of a separate biliary drainage catheter. This code is used when a healthcare provider inserts a stent, a tubelike device, to keep the bile duct open and allow for proper drainage. The procedure may also include diagnostic cholangiography, imaging guidance, balloon dilation, catheter exchange(s), and catheter removal(s) if necessary.

2. Official Description

The official description of CPT code 47539 is: ‘Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access, without placement of separate biliary drainage catheter.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure and administers anesthesia.
2. Using imaging guidance, such as fluoroscopy and/or ultrasound, 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 catheter/stent is advanced over the guide wire to the site of obstruction.
4. The provider may perform diagnostic cholangiography, which involves injecting a contrast dye into the bile ducts to visualize the area.
5. If necessary, the provider may perform balloon dilation to widen or expand the obstructed bile duct using a balloon catheter.
6. After the stent is in place, the provider removes the catheter and may schedule additional sessions if multiple stents are needed or if other bile ducts require intervention.

4. Qualifying circumstances

CPT 47539 is used for patients who require the placement of stent(s) into a bile duct through a new percutaneous access route. This procedure is typically performed on patients with bile duct obstructions or other conditions that require the use of a stent to maintain proper bile flow. The code specifically applies when a separate biliary drainage catheter is not placed during the procedure.

5. When to use CPT code 47539

CPT code 47539 should be used when a healthcare provider performs the placement of stent(s) into a bile duct through a new percutaneous access route, without the placement of a separate biliary drainage catheter. It is important to ensure that the procedure meets the specific criteria outlined in the code description to accurately report CPT 47539.

6. Documentation requirements

To support a claim for CPT 47539, the healthcare provider must document the following information:

• Reason for the procedure and the need for stent placement
• Details of the percutaneous access route used
• Specific imaging guidance techniques utilized, such as fluoroscopy and/or ultrasound
• Description of any balloon dilation performed
• Documentation of catheter exchange(s) and catheter removal(s) if applicable
• Associated radiological supervision and interpretation

7. Billing guidelines

When billing for CPT 47539, ensure that the procedure meets the criteria outlined in the code description. It is important to accurately report the placement of stent(s) into a bile duct through a new percutaneous access route, without the placement of a separate biliary drainage catheter. Modifier 59 (Distinct procedural service) may be appended if the procedure includes placement of double-barrel stents in a single duct or if multiple stents are placed through the same percutaneous access. It is important to review CPT and payer-specific guidelines for any additional requirements or considerations.

8. Historical information

CPT 47539 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 gastroenterologist performs the placement of a stent into a patient’s bile duct through a new percutaneous access route to alleviate a bile duct obstruction.
2. An interventional radiologist uses imaging guidance to insert a stent into a patient’s bile duct to maintain proper bile flow.
3. A hepatobiliary surgeon performs the placement of multiple stents in different bile ducts through the same percutaneous access route to address multiple obstructions.