How To Use CPT Code 47540

CPT 47540 describes the placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance, balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation. 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 47540?

CPT 47540 is used to describe the placement of stent(s) into a bile duct through a percutaneous access. This procedure involves the use of diagnostic cholangiography, imaging guidance, balloon dilation, catheter exchange(s), and catheter removal(s) when necessary. The provider also performs all associated radiological supervision and interpretation. The purpose of this procedure is to keep the bile duct open and allow for proper drainage.

2. Official Description

The official description of CPT code 47540 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, with placement of separate biliary drainage catheter (eg, external or internal-external)’

3. Procedure

1. The provider begins by prepping and anesthetizing the patient.
2. Contrast material is injected to visualize the liver and bile duct.
3. Using image guidance, the provider inserts a needle into the liver and advances it to the bile duct.
4. A guide wire is inserted through the needle, and a catheter/stent is advanced over the guide wire to the site of obstruction.
5. The provider expands a balloon inside the catheter to widen the obstructed bile duct.
6. The catheter is then pulled back, leaving the stent in place.
7. Additional stents may be placed in the same or other bile ducts.
8. A drainage catheter may be inserted over a guide wire for internal-external drainage or left in the bile duct for external drainage.
9. The outer end of the catheter is attached to a drainage system.
10. The provider secures the catheter and applies a compression bandage at the puncture site.

4. Qualifying circumstances

CPT 47540 is performed on patients who require the placement of stent(s) into a bile duct for proper drainage. The procedure is typically performed by a provider with expertise in interventional radiology. The patient must have a specific condition or obstruction in the bile duct that necessitates this intervention. The use of diagnostic cholangiography, imaging guidance, balloon dilation, catheter exchange(s), and catheter removal(s) may vary depending on the patient’s individual case.

5. When to use CPT code 47540

CPT code 47540 should be used when a provider performs the placement of stent(s) into a bile duct through a percutaneous access. This code is appropriate when the procedure includes diagnostic cholangiography, imaging guidance, balloon dilation, catheter exchange(s), and catheter removal(s) when necessary. It is important to review the specific documentation requirements and guidelines to ensure accurate reporting of this code.

6. Documentation requirements

To support a claim for CPT 47540, the provider must document the following information:

• Patient’s diagnosis and the need for the placement of stent(s) into the bile duct
• Details of the procedure, including the use of diagnostic cholangiography, imaging guidance, balloon dilation, catheter exchange(s), and catheter removal(s)
• Date and duration of the procedure
• Specific details of the stent(s) placed and any additional interventions performed
• Any complications or adverse events encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 47540, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should use the appropriate modifiers, if applicable, to indicate any distinct procedures or services performed. It is also important to review payer-specific guidelines to ensure accurate and compliant billing.

8. Historical information

CPT 47540 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 bile duct obstruction undergoes percutaneous placement of stent(s) for proper drainage.
2. A provider performs diagnostic cholangiography, imaging guidance, balloon dilation, catheter exchange(s), and catheter removal(s) during the placement of stent(s) into a bile duct for a patient with a specific diagnosis.