How To Use CPT Code 47541

CPT 47541 describes the placement of access through the biliary tree and into the small bowel to assist with an endoscopic biliary procedure. 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 47541?

CPT 47541 can be used to describe the placement of access through the biliary tree and into the small bowel to assist with an endoscopic biliary procedure. This code is used when the provider creates a new percutaneous access through the biliary tract and into the small intestine using imaging guidance, such as ultrasound or fluoroscopy. The procedure also includes diagnostic cholangiography, if performed, and all associated radiological supervision and interpretation.

2. Official Description

The official description of CPT code 47541 is: ‘Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access.’

3. Procedure

1. The provider creates a new percutaneous access through the biliary tract and into the small intestine using imaging guidance, such as ultrasound or fluoroscopy.
2. If necessary, the provider performs diagnostic cholangiography, a radiological procedure to image the inside of the bile ducts by injecting a contrast dye.
3. The procedure includes all associated radiological supervision and interpretation.

4. Qualifying circumstances

CPT 47541 is performed when access through the biliary tree and into the small bowel is needed to assist with an endoscopic biliary procedure. It should not be reported in conjunction with other codes that describe similar procedures or when there is existing catheter access. For the use of existing access through the biliary tree into the small bowel to assist with an endoscopic biliary procedure, different codes should be used.

5. When to use CPT code 47541

CPT code 47541 should be used when the provider creates new access through the biliary tree and into the small bowel to assist with an endoscopic biliary procedure. It should not be reported with other codes that describe similar procedures or when there is existing catheter access.

6. Documentation requirements

To support a claim for CPT 47541, the provider must document the following information:

• Reason for the procedure and the need for access through the biliary tree and into the small bowel
• Details of the imaging guidance used, such as ultrasound or fluoroscopy
• Date and time of the procedure
• Whether diagnostic cholangiography was performed and any findings
• Any associated radiological supervision and interpretation

7. Billing guidelines

When billing for CPT 47541, ensure that the procedure meets the criteria for this code and that it is not reported with other codes that describe similar procedures. The documentation should support the medical necessity and appropriateness of the procedure. Review CPT and payer-specific guidelines for any additional requirements or considerations.

8. Historical information

CPT 47541 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 provider performs CPT 47541 to create new access through the biliary tree and into the small bowel to assist with an endoscopic biliary procedure, using ultrasound guidance.
2. During an endoscopic biliary procedure, the provider is unable to establish access, so CPT 47541 is performed to create new access through the biliary tree and into the small bowel, using fluoroscopy guidance.
3. A patient requires an endoscopic biliary procedure, but existing catheter access is not suitable, so CPT 47541 is performed to create new access through the biliary tree and into the small bowel, using both ultrasound and fluoroscopy guidance.
4. Diagnostic cholangiography is performed during an endoscopic biliary procedure, and the provider also creates new access through the biliary tree and into the small bowel, so CPT 47541 is reported.
5. A provider performs CPT 47541 to create new access through the biliary tree and into the small bowel to assist with a rendezvous procedure, using ultrasound and fluoroscopy guidance.