How To Use CPT Code 47564

CPT 47564 describes the laparoscopic procedure for cholecystectomy with exploration of the common duct. 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 47564?

CPT 47564 is used to describe a laparoscopic surgical procedure called cholecystectomy with exploration of the common duct. This procedure involves the removal of the gallbladder using a laparoscope, which is a tubular instrument with a light source and camera. The provider also explores the common bile duct to check for stones and ensure the free passage of bile.

2. Official Description

The official description of CPT code 47564 is: ‘Laparoscopy, surgical; cholecystectomy with exploration of common duct.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes an incision just below the gallbladder and additional small incisions as necessary for instrumentation.
3. The abdominal cavity is expanded with carbon dioxide gas.
4. A laparoscope is inserted through one of the incisions to visualize the gallbladder.
5. The provider dissects the structures surrounding the gallbladder and clips the cystic artery and duct.
6. The common bile duct is explored to check for obstructions.
7. The gallbladder is dissected from the liver bed and the site is flushed with saline solution.
8. The carbon dioxide is released from the abdominal cavity and the instruments and tubes are removed.
9. The incision in the abdomen is sutured.

4. Qualifying circumstances

CPT 47564 is performed on patients with gallbladder disease who require a cholecystectomy. The procedure involves the exploration of the common duct to check for stones and ensure the free passage of bile. It is typically performed using a laparoscope, a minimally invasive approach. The patient must meet the medical necessity criteria for the procedure, and the provider must document the need for exploration of the common duct.

5. When to use CPT code 47564

CPT code 47564 should be used when a laparoscopic cholecystectomy is performed with exploration of the common duct. It is important to ensure that the documentation supports the need for exploration of the common duct and the removal of the gallbladder. If the procedure is performed without exploration of the common duct, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 47564, the provider must document the following information:

• Medical necessity for the procedure
• Details of the laparoscopic approach
• Specific findings during exploration of the common duct
• Any additional procedures performed during the same operative session
• Any complications or unexpected findings
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 47564, ensure that the procedure meets the criteria for medical necessity and that the documentation supports the need for exploration of the common duct. It is important to follow the specific guidelines provided by the payer for proper reimbursement. Additionally, be aware of any bundling or unbundling issues with other procedures performed during the same operative session.

8. Historical information

CPT 47564 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates to the code since its addition.

9. Examples

1. A patient with symptomatic gallstones undergoes a laparoscopic cholecystectomy with exploration of the common duct to check for stones.
2. A patient with suspected common bile duct stones undergoes a laparoscopic cholecystectomy with exploration of the common duct, which reveals the presence of stones that are subsequently removed.
3. A patient with gallbladder disease and a history of common bile duct stones undergoes a laparoscopic cholecystectomy with exploration of the common duct to ensure the free passage of bile.
4. A patient with gallbladder disease and jaundice undergoes a laparoscopic cholecystectomy with exploration of the common duct to identify and address any obstructions.
5. A patient with gallbladder disease and pancreatitis undergoes a laparoscopic cholecystectomy with exploration of the common duct to rule out any common bile duct stones as the cause of the pancreatitis.
6. A patient with gallbladder disease and abnormal liver function tests undergoes a laparoscopic cholecystectomy with exploration of the common duct to assess the biliary system.
7. A patient with gallbladder disease and recurrent episodes of abdominal pain undergoes a laparoscopic cholecystectomy with exploration of the common duct to rule out any common bile duct stones as the cause of the pain.
8. A patient with gallbladder disease and a history of choledocholithiasis undergoes a laparoscopic cholecystectomy with exploration of the common duct to ensure the absence of any residual stones.
9. A patient with gallbladder disease and suspected biliary dyskinesia undergoes a laparoscopic cholecystectomy with exploration of the common duct to assess the biliary system.
10. A patient with gallbladder disease and suspected common bile duct strictures undergoes a laparoscopic cholecystectomy with exploration of the common duct to evaluate the biliary system.