How To Use CPT Code 47554

CPT 47554 describes the procedure of biliary endoscopy, specifically the percutaneous approach via a T-tube or other tract, with the removal of calculus or calculi. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 47554?

CPT 47554 is used to describe a specific procedure known as biliary endoscopy. This procedure involves the use of a biliary endoscope, or choledochoscope, which is a tubular instrument equipped with a light source and camera. The purpose of the procedure is to visualize the biliary ducts for any blockages and to remove one or more stones or calculi. The provider inserts the choledochoscope through an existing tube in the abdominal wall, which is placed in association with another procedure.

2. Official Description

The official description of CPT code 47554 is: ‘Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. Using fluoroscopic guidance, the provider inserts the choledochoscope into a T-tube or percutaneous transhepatic drainage tube in the abdominal wall.
3. The provider examines the biliary ducts and may perform cholangiography, an imaging study, to visualize the ducts by injecting dye.
4. Through the working channel of the scope, the provider inserts a forceps or other grasping instrument to remove one or more stones from the biliary duct.
5. The provider withdraws all instruments and removes the choledochoscope.

4. Qualifying circumstances

CPT 47554 is performed on patients who have blockages in their biliary ducts and require the removal of stones or calculi. The procedure is typically done when a T-tube or percutaneous transhepatic drainage tube is already in place in the abdominal wall. The provider must use a biliary endoscope and perform the procedure percutaneously via the existing tube or tract.

5. When to use CPT code 47554

CPT code 47554 should be used when the provider performs a biliary endoscopy procedure using a percutaneous approach via a T-tube or other tract and removes one or more stones or calculi. It is important to note that this code should not be reported if the procedure is performed using a different approach or if stones or calculi are not removed.

6. Documentation requirements

To support a claim for CPT 47554, the provider must document the following information:

• Reason for the procedure and the presence of biliary duct blockage
• Details of the procedure, including the use of fluoroscopic guidance and cholangiography if performed
• Number of stones or calculi removed
• Date and duration of the procedure
• Any complications or additional interventions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 47554, ensure that the procedure meets the specific criteria outlined in the code description. It is important to report any additional procedures or services separately, such as fluoroscopic guidance or cholangiography. Select the appropriate code from the range 47550-47556 if the provider performs biliary endoscopy using different approaches or procedures.

8. Historical information

CPT 47554 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with biliary duct blockage undergoes a percutaneous biliary endoscopy procedure via a T-tube, during which the provider removes multiple stones.
2. Using a percutaneous approach via a T-tube, the provider performs biliary endoscopy on a patient with calculi in the biliary duct and successfully removes the stones.
3. A biliary endoscopy procedure is performed percutaneously via a T-tube in a patient with a history of biliary duct blockage, and the provider removes a single large calculus.
4. During a percutaneous biliary endoscopy procedure via a T-tube, the provider removes multiple small calculi from the biliary duct of a patient with recurrent blockages.
5. A patient with a T-tube in place undergoes a percutaneous biliary endoscopy procedure to remove a single large stone causing biliary duct obstruction.
6. Using a percutaneous approach via a T-tube, the provider performs biliary endoscopy on a patient with a history of recurrent biliary duct stones and successfully removes multiple calculi.
7. A percutaneous biliary endoscopy procedure is performed via a T-tube in a patient with a known biliary duct blockage, and the provider removes a single large calculus causing the obstruction.
8. During a percutaneous biliary endoscopy procedure via a T-tube, the provider removes multiple small calculi from the biliary duct of a patient with chronic biliary duct blockage.
9. A patient with a T-tube in place undergoes a percutaneous biliary endoscopy procedure to remove a single large stone causing recurrent biliary duct obstruction.