How To Use CPT Code 48500

CPT 48500 describes the marsupialization of a pancreatic cyst, which involves making an incision and leaving it partially open like a pouch. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 48500?

CPT 48500 is used to describe the surgical procedure known as marsupialization of a pancreatic cyst. During this procedure, the provider makes a small incision above the cyst and dissects down to the pancreas. The cyst is then opened with incisions, drained of all material, and the leaflets of the incised cyst are stitched to the surrounding tissue to keep it open for continuous drainage. The provider may also place a drain to aid in healing. Finally, the abdominal wound is closed in layers.

2. Official Description

The official description of CPT code 48500 is: ‘Marsupialization of pancreatic cyst; incising it and leaving it partially open, like a pouch.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. A small incision is made above the identified pancreatic cyst.
3. The provider dissects down to the pancreas.
4. The cyst is opened with incisions.
5. All material within the cyst is drained.
6. The leaflets of the incised cyst are stitched to the surrounding tissue to keep it open for continuous drainage.
7. A drain may be placed to aid in healing.
8. Hemostasis is ensured.
9. The abdominal wound is closed in layers.

4. Qualifying circumstances

CPT 48500 is performed on patients with pancreatic cysts that require marsupialization. The procedure is typically performed by a qualified healthcare provider who has the necessary training and experience. The patient must be appropriately prepped and anesthetized before the procedure can take place.

5. When to use CPT code 48500

CPT code 48500 should be used when a provider performs the marsupialization procedure on a pancreatic cyst. It is important to note that this code should not be used for other procedures or interventions on the pancreas that do not involve marsupialization of a cyst.

6. Documentation requirements

To support a claim for CPT 48500, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for marsupialization of the pancreatic cyst
• Details of the procedure, including the incision, opening of the cyst, drainage of material, and stitching of the incised cyst to surrounding tissue
• Use of a drain, if applicable
• Hemostasis measures taken
• Details of the abdominal wound closure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 48500, ensure that the procedure performed matches the description of marsupialization of a pancreatic cyst. It is important to accurately document and code the procedure to avoid any billing errors or denials. CPT code 48500 should not be reported with other codes that do not involve marsupialization of a pancreatic cyst.

8. Historical information

CPT 48500 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition. However, it is worth noting that as of 2017, CPT 48500 is listed under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes marsupialization of a pancreatic cyst to ensure continuous drainage and prevent reformation of the cyst.
2. A healthcare provider performs the procedure on a patient with a large pancreatic cyst that is causing symptoms and complications.
3. Marsupialization of a pancreatic cyst is performed as part of the treatment plan for a patient with a history of recurrent cysts.
4. A provider performs the procedure on a patient with a pancreatic cyst that is at risk of becoming infected or causing other complications.
5. Marsupialization of a pancreatic cyst is performed to alleviate pain and improve the patient’s quality of life.
6. A healthcare provider performs the procedure on a patient with a pancreatic cyst that is obstructing the normal functioning of the pancreas.
7. Marsupialization of a pancreatic cyst is performed as a preventive measure for a patient with a high risk of developing pancreatic cysts.
8. A provider performs the procedure on a patient with a pancreatic cyst that is causing compression of nearby organs.
9. Marsupialization of a pancreatic cyst is performed to aid in the diagnosis and management of a patient with an unclear pancreatic mass.
10. A healthcare provider performs the procedure on a patient with a pancreatic cyst that is causing significant discomfort and affecting their daily activities.