How To Use CPT Code 48150

CPT 48150 describes a surgical procedure known as a Whipple-type procedure, which involves the removal of a significant portion of the pancreas, along with the duodenum, part of the bile duct, and distal stomach. This article will provide an overview of CPT code 48150, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 48150?

CPT 48150 is a code used to describe a surgical procedure called a Whipple-type procedure. This procedure involves the removal of a substantial portion of the pancreas, along with the duodenum, part of the bile duct, and distal stomach. It also includes the reconstruction and connection of the pancreas to the jejunum, a part of the small intestine.

2. Official Description

The official description of CPT code 48150 is: ‘Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy, and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy.’

3. Procedure

1. The surgeon begins by making an incision over the pancreas and duodenum region to access the organs.
2. Next, the surgeon performs the excision of the malignant parts of the pancreas, total duodenum, part of the stomach, and the bile duct.
3. The gastrointestinal tract is then reconstructed through various anastomosis procedures. The surgeon connects the pancreas to the jejunum through pancreatojejunostomy, the common bile duct to the intestine through choledochoenterostomy, and the stomach to the jejunum through gastrojejunostomy.
4. Finally, the incision is closed using sutures.

4. Qualifying circumstances

CPT code 48150 is used for patients who require a Whipple-type procedure due to malignancy of the pancreas and the duodenum. The procedure involves the removal of the pancreas, duodenum, part of the stomach, and the bile duct. It is important to note that this procedure is performed by a qualified surgeon and is typically reserved for cases where the cancer has spread to these organs.

5. When to use CPT code 48150

CPT code 48150 should be used when a Whipple-type procedure is performed, involving the removal of a significant portion of the pancreas, duodenum, part of the stomach, and the bile duct. It is important to ensure that the procedure includes pancreatojejunostomy. If the procedure does not involve pancreatojejunostomy, a different CPT code should be used.

6. Documentation requirements

When reporting CPT code 48150, the following documentation is required:

• Clear indication of the patient’s diagnosis and the need for the Whipple-type procedure
• Details of the specific parts of the pancreas, duodenum, stomach, and bile duct that were excised
• Documentation of the anastomosis procedures performed, including pancreatojejunostomy, choledochoenterostomy, and gastrojejunostomy
• Date of the procedure and the duration of the surgery
• Any additional relevant information or complications encountered during the procedure

7. Billing guidelines

When billing for CPT code 48150, it is important to ensure that the procedure performed aligns with the description of the code. Additionally, it is crucial to follow any specific billing guidelines provided by the payer. It is also important to note that CPT code 48150 should not be reported with other codes that have been performed in the previous seven days. Proper modifier usage should be applied if necessary.

8. Historical information

CPT code 48150 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. It is important to stay updated with any changes or revisions to the code in future editions of the CPT manual.

9. Examples

1. A patient with pancreatic and duodenal malignancy undergoes a Whipple-type procedure, including pancreatojejunostomy, choledochoenterostomy, and gastrojejunostomy.
2. A surgeon performs a Whipple-type procedure on a patient with advanced pancreatic cancer, removing the pancreas, duodenum, part of the stomach, and the bile duct, and reconstructing the gastrointestinal tract through anastomosis.
3. A Whipple-type procedure is performed on a patient with a malignant tumor in the pancreas and duodenum, involving the removal of the affected organs and the connection of the remaining parts to the jejunum.
4. A surgeon performs a Whipple-type procedure on a patient with a complex pancreatic tumor, excising the pancreas, duodenum, part of the stomach, and the bile duct, and reconstructing the gastrointestinal tract through anastomosis.