How To Use CPT Code 47780

CPT 47780 describes the surgical procedure known as Roux-en-Y anastomosis, which involves the connection of the biliary ducts to the gastrointestinal tract. This article will provide an overview of CPT code 47780, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 47780?

CPT 47780 is used to describe a surgical procedure in which the provider creates a connection between the biliary ducts and the gastrointestinal tract. This procedure, known as Roux-en-Y anastomosis, is performed to restore the flow of bile in cases where there is a blockage caused by a biliary tumor or other conditions.

2. Official Description

The official description of CPT code 47780 is: ‘Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract.’

3. Procedure

1. The provider begins by making an incision in the abdomen after the patient has been prepped and anesthetized.
2. They then proceed to incise the small intestine and connect one portion of it to an extrahepatic duct.
3. Next, the provider joins the other end of the intestine to itself at another location in the small intestine, creating a Y-shaped anastomosis.
4. After completing the anastomosis, the provider irrigates the area, checks for any signs of bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

CPT 47780 is typically performed in cases where there is a blockage in the biliary ducts, such as from a biliary tumor or other conditions. The procedure is intended to restore the flow of bile by creating a connection between the biliary ducts and the gastrointestinal tract. It is important to note that this procedure is performed by a qualified healthcare professional and requires specific expertise in surgical techniques.

5. When to use CPT code 47780

CPT code 47780 should be used when a provider performs a Roux-en-Y anastomosis to connect the extrahepatic biliary ducts to the gastrointestinal tract. This code is appropriate for cases where there is a blockage in the biliary ducts and the procedure is necessary to restore the flow of bile. It is important to ensure that the documentation supports the medical necessity of the procedure and that it is performed by a qualified healthcare professional.

6. Documentation requirements

To support a claim for CPT code 47780, the provider must document the following information:

• Medical necessity for the procedure, including the presence of a blockage in the biliary ducts
• Details of the procedure performed, including the specific anatomical structures involved
• Any additional procedures or techniques used during the surgery
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and any follow-up appointments scheduled
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 47780, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should also ensure that the documentation supports the medical necessity of the procedure and that it is performed by a qualified healthcare professional. It is also important to follow any additional billing guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT code 47780 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement purposes.

9. Examples

1. A patient with a biliary tumor undergoes a Roux-en-Y anastomosis to restore the flow of bile.
2. A provider performs a Roux-en-Y anastomosis to treat a patient with a blockage in the biliary ducts caused by a gallstone.
3. A patient with a congenital biliary anomaly undergoes a Roux-en-Y anastomosis to improve bile flow.
4. A provider performs a Roux-en-Y anastomosis as part of a liver transplant procedure to connect the biliary ducts to the gastrointestinal tract.
5. A patient with a history of biliary strictures undergoes a Roux-en-Y anastomosis to alleviate the blockage and improve bile flow.
6. A provider performs a Roux-en-Y anastomosis to treat a patient with a biliary obstruction caused by a pancreatic tumor.
7. A patient with primary sclerosing cholangitis undergoes a Roux-en-Y anastomosis to improve bile flow and alleviate symptoms.
8. A provider performs a Roux-en-Y anastomosis to treat a patient with a biliary stricture caused by chronic pancreatitis.
9. A patient with a history of biliary stones undergoes a Roux-en-Y anastomosis to prevent future blockages and improve bile flow.
10. A provider performs a Roux-en-Y anastomosis to treat a patient with a biliary obstruction caused by a bile duct injury.