How To Use CPT Code 47544

CPT 47544 describes the percutaneous removal of calculi or debris from the biliary ducts and/or gallbladder, including the destruction of calculi by various methods such as mechanical or electrohydraulic lithotripsy. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 47544?

CPT 47544 is used to describe the percutaneous removal of calculi or debris from the biliary ducts and/or gallbladder. This procedure involves the insertion of a catheter through a small incision in the skin to remove stonelike material from the bile ducts and/or gallbladder. The provider may use various methods, such as mechanical or electrohydraulic lithotripsy, to destroy the calculi. Image guidance, such as fluoroscopy, is used during the procedure, and radiological supervision and interpretation are included.

2. Official Description

The official description of CPT code 47544 is: ‘Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)’

3. Procedure

1. The provider prepares the patient and uses fluoroscopic guidance to insert a needle into the liver and advance it to the bile duct.
2. A guide wire is inserted through the needle, and a catheter is advanced over the guide wire into the bile ducts.
3. The provider removes the calculi or debris from the biliary ducts or gallbladder, potentially using mechanical crushing or electrohydraulic lithotripsy.
4. If necessary, the provider may crush the stones to make them small enough to remove through the catheter.
5. The procedure includes radiological supervision and interpretation.

4. Qualifying circumstances

CPT 47544 is performed on patients with calculi or debris in the biliary ducts and/or gallbladder. It is important to note that this code should not be reported if no calculi or debris are found, even if a removal device is deployed. Additionally, CPT 47544 should not be reported in conjunction with codes 43264 or 47554. It is also not appropriate to report CPT 47544 in conjunction with codes 47531-47543 for incidental removal of debris. The procedure requires image guidance, such as fluoroscopy, and all associated radiological supervision and interpretation are included.

5. When to use CPT code 47544

CPT code 47544 should be used when the provider performs the percutaneous removal of calculi or debris from the biliary ducts and/or gallbladder, including the destruction of calculi by any method. This code should not be reported if no calculi or debris are found during the procedure. It is important to use this code in conjunction with the appropriate primary procedure code.

6. Documentation requirements

To support a claim for CPT 47544, the provider must document the following information:

• Patient’s diagnosis indicating the presence of calculi or debris in the biliary ducts and/or gallbladder
• Specific methods used to destroy the calculi, such as mechanical or electrohydraulic lithotripsy
• Date of the procedure
• Start and end time of the procedure
• Details of the removal process, including any mechanical crushing or lithotripsy performed
• Documentation of image guidance, such as fluoroscopy
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 47544, ensure that the procedure meets the criteria for percutaneous removal of calculi or debris from the biliary ducts and/or gallbladder. This code should not be reported if no calculi or debris are found during the procedure. It is important to use the appropriate primary procedure code in conjunction with CPT 47544. Additionally, be aware that CPT 47544 is an add-on code and should not be reported without an appropriate primary code. Review CPT and payer-specific guidelines for any additional requirements or considerations.

8. Historical information

CPT 47544 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 percutaneous removal of calculi from the biliary ducts of a patient with cholelithiasis.
2. A patient presents with debris in the gallbladder, and the provider performs percutaneous removal of the debris using mechanical crushing.
3. A provider uses electrohydraulic lithotripsy to destroy calculi in the biliary ducts of a patient with choledocholithiasis.
4. A patient with biliary sludge undergoes percutaneous removal of the sludge from the gallbladder.
5. A provider performs percutaneous removal of calculi from the biliary ducts and gallbladder of a patient with cholangitis.
6. A patient with obstructive jaundice undergoes percutaneous removal of calculi from the biliary ducts.