How To Use CPT Code 48545

CPT 48545 describes the repair and reconstruction of the pancreas to restore its function after a traumatic injury to the abdomen. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 48545?

CPT 48545 can be used to describe the surgical repair and reconstruction of the pancreas to restore its function following a traumatic injury to the abdomen. This code is used when the provider performs an upper midline incision in the abdomen, identifies the damaged area in the pancreas, sutures or staples any torn tissues, and closes the incision.

2. Official Description

The official description of CPT code 48545 is: ‘Pancreatorrhaphy for injury.’

3. Procedure

1. The provider makes an upper midline incision in the abdomen.
2. He or she dissects down to the pancreas and identifies the area of damage.
3. The provider sutures or staples any torn tissues in the pancreas.
4. A drainage tube may be inserted.
5. The provider irrigates the area, checks for bleeding, removes any instruments, and closes the incision.

4. Qualifying circumstances

Patients eligible to receive CPT 48545 services are those who have experienced a traumatic injury to the abdomen resulting in damage to the pancreas. The procedure is performed by a qualified provider who is able to repair and reconstruct the pancreas.

5. When to use CPT code 48545

CPT code 48545 should be used when a provider performs a pancreatorrhaphy to repair and reconstruct the pancreas after a traumatic injury to the abdomen. This code should not be used for other procedures or conditions unrelated to the pancreas.

6. Documentation requirements

To support a claim for CPT 48545, the provider must document the following information:

• Details of the traumatic injury to the abdomen
• Specific steps taken during the pancreatorrhaphy procedure
• Any additional procedures performed in conjunction with CPT 48545
• Any complications or unexpected findings during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 48545, ensure that the procedure is performed to repair and reconstruct the pancreas after a traumatic injury to the abdomen. Modifier 22, Increased procedural services, may be added if additional work is performed in conjunction with CPT 48545. It is important to review payer guidelines and documentation requirements to ensure accurate billing and reimbursement.

8. Historical information

CPT 48545 was added to the Current Procedural Terminology system on January 1, 1994. It was initially described as ‘Pancreatorrhaphy for trauma’ and has remained unchanged since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient sustains a traumatic injury to the abdomen in a car accident, resulting in damage to the pancreas. The provider performs a pancreatorrhaphy to repair and reconstruct the pancreas.
2. During a physical altercation, a patient is injured in the abdomen, causing damage to the pancreas. The provider performs a pancreatorrhaphy to repair the damaged tissues.
3. A patient falls from a significant height, resulting in a traumatic injury to the abdomen and damage to the pancreas. The provider performs a pancreatorrhaphy to restore the function of the pancreas.
4. Following a sports-related injury, a patient experiences a traumatic injury to the abdomen, leading to damage in the pancreas. The provider performs a pancreatorrhaphy to repair and reconstruct the pancreas.
5. During a surgical procedure, a patient experiences an accidental injury to the abdomen, causing damage to the pancreas. The provider performs a pancreatorrhaphy to repair the damaged tissues.
6. A patient is involved in a workplace accident, resulting in a traumatic injury to the abdomen and damage to the pancreas. The provider performs a pancreatorrhaphy to restore the function of the pancreas.
7. Following a fall down the stairs, a patient sustains a traumatic injury to the abdomen, leading to damage in the pancreas. The provider performs a pancreatorrhaphy to repair and reconstruct the pancreas.
8. During a physical assault, a patient is injured in the abdomen, causing damage to the pancreas. The provider performs a pancreatorrhaphy to repair the damaged tissues.
9. A patient is involved in a motorcycle accident, resulting in a traumatic injury to the abdomen and damage to the pancreas. The provider performs a pancreatorrhaphy to restore the function of the pancreas.
10. Following a fall from a ladder, a patient experiences a traumatic injury to the abdomen, leading to damage in the pancreas. The provider performs a pancreatorrhaphy to repair and reconstruct the pancreas.