How To Use CPT Code 47605

CPT 47605 describes the surgical excision of the gallbladder, specifically with cholangiography. 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 47605?

CPT 47605 can be used to describe the surgical removal of the gallbladder, a small organ responsible for storing bile, with the additional use of cholangiography. This code is used when the provider injects dye to visualize the biliary ducts using X-ray images during the procedure.

2. Official Description

The official description of CPT code 47605 is: ‘Cholecystectomy; with cholangiography.’ This code is specifically for the surgical removal of the gallbladder with the use of cholangiography to visualize the biliary ducts.

3. Procedure

1. The provider begins by making an incision in the right upper abdomen and accessing the gallbladder.
2. They then dissect the structures surrounding the gallbladder and clip the cystic artery and duct.
3. Dye is injected into the common duct to visualize the biliary tract and check for any stones or obstructions.
4. The provider records the cholangiographic images for documentation purposes.
5. The gallbladder is then dissected from the liver bed.
6. The site is irrigated and a drain may be inserted for fluid drainage.
7. Any instruments are removed, bleeding is checked, and the incision is closed with sutures in layers.

4. Qualifying circumstances

CPT 47605 is used for patients who require the surgical removal of the gallbladder due to gallbladder disease. The procedure may involve the use of cholangiography to visualize the biliary ducts. It is important to note that this code is specifically for the excision of the gallbladder and should not be used for laparoscopic approaches, which have their own specific codes.

5. When to use CPT code 47605

CPT code 47605 should be used when the provider performs a surgical cholecystectomy with the additional use of cholangiography to visualize the biliary ducts. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 47605, the provider must document the following information:

• Patient’s diagnosis and indication for gallbladder removal
• Use of cholangiography during the procedure
• Details of the surgical approach and technique
• Any additional procedures performed during the same operative session
• Any complications or unexpected findings
• Post-operative care instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 47605, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the use of cholangiography during the surgical excision of the gallbladder. Additionally, be aware of any specific guidelines or requirements from insurance payers regarding the use of this code.

8. Historical information

CPT 47605 was added to the Current Procedural Terminology system on January 1, 1990. It has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes a surgical cholecystectomy with cholangiography to remove their gallbladder due to gallbladder disease.
2. A provider performs a cholecystectomy with cholangiography on a patient with symptomatic gallstones.
3. A patient with biliary dyskinesia undergoes a surgical cholecystectomy with cholangiography to alleviate their symptoms.
4. A provider performs a cholecystectomy with cholangiography on a patient with acute cholecystitis.
5. A patient with choledocholithiasis undergoes a surgical cholecystectomy with cholangiography to remove the gallbladder and address the obstruction in the common bile duct.
6. A provider performs a cholecystectomy with cholangiography on a patient with gallbladder polyps.
7. A patient with porcelain gallbladder undergoes a surgical cholecystectomy with cholangiography to prevent potential complications.
8. A provider performs a cholecystectomy with cholangiography on a patient with gallbladder cancer.
9. A patient with gallbladder empyema undergoes a surgical cholecystectomy with cholangiography to treat the infection.
10. A provider performs a cholecystectomy with cholangiography on a patient with gallbladder adenomyomatosis.