How To Use CPT Code 47741

CPT 47741 describes the procedure known as cholecystoenterostomy with Roux-en-Y and gastroenterostomy. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 47741?

CPT 47741 is used to describe a surgical procedure in which a connection is created between the gallbladder and the small intestine, known as cholecystoenterostomy. This procedure also involves the creation of a new connection between the stomach and the small intestine, called gastroenterostomy. The purpose of this procedure is to restore gastric and biliary function in patients with conditions such as inoperable pancreatic cancer.

2. Official Description

The official description of CPT code 47741 is: ‘Cholecystoenterostomy; Roux-en-Y with gastroenterostomy.’

3. Procedure

1. The surgeon begins by making an incision in the abdomen and assessing the gallbladder and small intestine for any abnormalities.
2. Both structures are then incised, and a loop of the small intestine is brought up to the gallbladder.
3. The surgeon stitches the gallbladder and small intestine together, creating a passage for the flow of bile.
4. Next, an opening is created between the lower portion of the stomach and the small intestine to allow the passage of digestive contents.
5. The surgeon stitches the free end of the intestine to another part of the small intestine, forming a Y-shaped anastomosis within the intestine.
6. The area is irrigated, checked for bleeding, and any instruments are removed before closing the incision.

4. Qualifying circumstances

CPT 47741 is performed in cases where there is a need to restore gastric and biliary function. It is typically used for patients with conditions such as inoperable pancreatic cancer. The procedure involves creating connections between the gallbladder and small intestine, as well as between the stomach and small intestine.

5. When to use CPT code 47741

CPT code 47741 should be used when performing cholecystoenterostomy with Roux-en-Y and gastroenterostomy. It is important to ensure that the procedure meets the specific criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT 47741, the surgeon must document the following information:

• Patient’s diagnosis and the need for the procedure
• Details of the procedure performed, including the specific structures involved
• Date of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 47741, it is important to ensure that the procedure performed meets the specific criteria outlined in the official description. It is also important to follow any additional billing guidelines provided by the payer. CPT code 47741 should not be reported with other codes unless specifically indicated by the payer.

8. Historical information

CPT code 47741 was added to the Current Procedural Terminology system on January 1, 1995. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A surgeon performs cholecystoenterostomy with Roux-en-Y and gastroenterostomy to restore gastric and biliary function in a patient with inoperable pancreatic cancer.
2. During the procedure, the surgeon creates connections between the gallbladder and small intestine, as well as between the stomach and small intestine, to provide pathways for the flow of bile and digestive contents.
3. The surgeon documents the details of the procedure, including the specific structures involved, the date of the procedure, and any additional relevant information.
4. After the procedure, the surgeon signs the documentation to support the claim for CPT code 47741.
5. Another surgeon performs cholecystoenterostomy with anastomosis to the small intestine, using CPT code 47740, for a patient with a blocked common duct.
6. A different surgeon performs cholecystoenterostomy with anastomosis to the colon and small intestine, using CPT code 47743, for a patient with a complex biliary condition.
7. Yet another surgeon performs cholecystoenterostomy with anastomosis to the colon, stomach, and small intestine, using CPT code 47745, for a patient with multiple gastrointestinal issues.
8. Each of these procedures requires careful documentation and adherence to the specific criteria outlined in the official descriptions of the respective CPT codes.
9. It is important for surgeons to accurately report the appropriate CPT code based on the specific procedure performed and the structures involved.
10. By following the documentation requirements and billing guidelines, surgeons can ensure accurate reporting and reimbursement for procedures such as cholecystoenterostomy with Roux-en-Y and gastroenterostomy.