How To Use CPT Code 47543

CPT 47543 describes the percutaneous endoluminal biopsy of the biliary tree, including imaging guidance and 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 47543?

CPT 47543 is used to describe the percutaneous endoluminal biopsy of the biliary tree, which involves obtaining tissue or cells from the bile ducts and/or gallbladder for diagnostic analysis. This procedure is performed using various biopsy methods, such as brush, forceps, and/or needle, and includes imaging guidance and radiological supervision and interpretation.

2. Official Description

The official description of CPT code 47543 is: ‘Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (List separately in addition to code for primary procedure).’ This code should be used in conjunction with the primary procedure codes related to the biliary tract.

3. Procedure

1. During another percutaneous procedure on the biliary tract, the healthcare provider inserts a catheter percutaneously to access the bile ducts and/or gallbladder.
2. The provider then uses various biopsy methods, such as a brush, forceps, and/or needle, to obtain tissue or cells for diagnostic analysis.
3. The procedure is performed under image guidance, such as fluoroscopy, which allows the provider to monitor the procedure in real-time.
4. The provider also provides radiological supervision and interpretation to ensure accurate placement of the biopsy instruments and to assess the obtained tissue or cells.

4. Qualifying circumstances

CPT 47543 is used when a percutaneous endoluminal biopsy of the biliary tree is performed. This procedure is typically done during another percutaneous procedure on the biliary tract. The biopsy may involve the use of a brush, forceps, and/or needle to obtain tissue or cells for diagnostic analysis. The procedure requires imaging guidance, such as fluoroscopy, and includes radiological supervision and interpretation.

5. When to use CPT code 47543

CPT code 47543 should be used when a percutaneous endoluminal biopsy of the biliary tree is performed, along with the primary procedure codes related to the biliary tract. It is important to ensure that the biopsy is performed using imaging guidance and includes radiological supervision and interpretation. This code should not be reported without an appropriate primary code.

6. Documentation requirements

To support a claim for CPT 47543, the healthcare provider must document the following information:

• Indication for the biopsy and the need for diagnostic analysis
• Details of the biopsy method(s) used, such as brush, forceps, and/or needle
• Date of the procedure and the duration of the biopsy
• Imaging guidance used, such as fluoroscopy
• Radiological supervision and interpretation provided
• Any complications or additional findings during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 47543, ensure that the procedure meets the criteria for a percutaneous endoluminal biopsy of the biliary tree. This code should be reported in addition to the primary procedure codes related to the biliary tract. It is important to follow CPT and payer-specific guidelines for proper reporting. Note that this code includes imaging guidance and radiological supervision and interpretation, so separate coding for these services is not necessary.

8. Historical information

CPT 47543 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 healthcare provider performs a percutaneous endoluminal biopsy of the biliary tree using a brush and fluoroscopy guidance during a percutaneous cholangiography procedure.
2. During a percutaneous transhepatic cholangiography, a provider obtains tissue samples from the bile ducts using forceps and fluoroscopy guidance for diagnostic analysis.
3. A patient undergoes a percutaneous endoluminal biopsy of the biliary tree using a needle and imaging guidance during a percutaneous transhepatic cholangiography procedure.
4. Using a combination of brush and forceps, a healthcare provider performs a percutaneous endoluminal biopsy of the biliary tree during a percutaneous transhepatic cholangiography, including radiological supervision and interpretation.
5. During a percutaneous transhepatic cholangiography, a provider performs a percutaneous endoluminal biopsy of the biliary tree using a needle and fluoroscopy guidance, along with catheter placement and biliary drainage.