How To Use CPT Code 47801

CPT 47801 describes the placement of a choledochal stent, a procedure performed by a healthcare provider to relieve narrowing in the bile duct. 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 47801?

CPT 47801 can be used to describe the placement of a choledochal stent, which is a thin expandable tube inserted into the bile duct to prevent obstruction and provide support after dilation. This code is used when a healthcare provider performs the procedure to relieve narrowing in the extrahepatic portion of the biliary tract.

2. Official Description

The official description of CPT code 47801 is: ‘Placement of choledochal stent.’

3. Procedure

1. The healthcare provider prepares the patient and administers anesthesia.
2. An incision is made in the right upper abdomen to access the bile duct.
3. The provider identifies the area of narrowing in the bile duct and may use a balloon to dilate it.
4. A stent is inserted over a guidewire to prevent recurrence of the narrowing.
5. An endoscope or tube may be used to assist with stent placement.
6. A cholangiogram, a radiograph of the bile ducts, may be performed.
7. A drain may be fastened in place to aid in healing.
8. The provider ensures hemostasis and closes the abdominal incision.

4. Qualifying circumstances

CPT 47801 is performed on patients with narrowing in the extrahepatic portion of the biliary tract. The procedure is typically done when other interventions have failed to relieve the narrowing. It is important to note that this procedure is performed by a healthcare provider and requires appropriate prepping and anesthesia.

5. When to use CPT code 47801

CPT code 47801 should be used when a healthcare provider performs the placement of a choledochal stent to relieve narrowing in the bile duct. It is important to ensure that the procedure is performed on the extrahepatic portion of the biliary tract and that other interventions have been unsuccessful.

6. Documentation requirements

To support a claim for CPT 47801, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for the choledochal stent placement
• Details of the procedure, including the incision, dilation, stent insertion, and use of an endoscope or tube
• Whether a cholangiogram was performed
• Any additional procedures or interventions performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 47801, ensure that the procedure is performed by a qualified healthcare provider and that the documentation supports the medical necessity of the choledochal stent placement. It is important to follow the specific guidelines provided by the payer and to use the appropriate modifiers if required. Additionally, consider any bundling or unbundling rules that may apply to this procedure.

8. Historical information

CPT 47801 was added to the Current Procedural Terminology system on January 1, 1990. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A healthcare provider performs the placement of a choledochal stent to relieve narrowing in the bile duct of a patient with cholelithiasis.
2. During a surgical procedure, a provider inserts a choledochal stent to alleviate the narrowing in the extrahepatic portion of the biliary tract in a patient with a common bile duct stricture.
3. A patient with recurrent bile duct strictures undergoes the placement of a choledochal stent to maintain biliary drainage.
4. A healthcare provider performs the procedure to relieve narrowing in the bile duct of a patient with a history of chronic pancreatitis.
5. During an open surgery, a provider inserts a choledochal stent to alleviate the narrowing in the extrahepatic portion of the biliary tract in a patient with a bile duct tumor.
6. A patient with a history of biliary tract infections undergoes the placement of a choledochal stent to prevent obstruction and promote bile flow.
7. A healthcare provider performs the procedure to relieve narrowing in the bile duct of a patient with primary sclerosing cholangitis.
8. During a surgical intervention, a provider inserts a choledochal stent to alleviate the narrowing in the extrahepatic portion of the biliary tract in a patient with a bile duct injury.
9. A patient with recurrent bile duct stones undergoes the placement of a choledochal stent to maintain biliary drainage and prevent future obstructions.
10. A healthcare provider performs the procedure to relieve narrowing in the bile duct of a patient with a history of biliary strictures.