How To Use CPT Code 48556

CPT 48556 describes the removal of a previously transplanted donor pancreas in a patient when the transplanted pancreas fails to function normally. 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 48556?

CPT 48556 can be used to describe the procedure in which a provider removes a previously transplanted donor pancreas from a patient when the transplanted pancreas is not functioning properly. This code is used when the provider performs an upper midline incision in the abdomen, detaches the pancreatic allograft from its attachments, ligates the blood vessels, and removes the allograft. The provider then closes the incision.

2. Official Description

The official description of CPT code 48556 is: ‘Removal of transplanted pancreatic allograft.’

3. Procedure

1. The provider makes an upper midline incision in the abdomen.
2. The provider dissects down to the area of the pancreas.
3. Any adhesions from the prior surgery are freed.
4. The area is inspected for the presence of infection.
5. The provider detaches the pancreatic allograft from its attachments.
6. The blood vessels are ligated or tied off.
7. The allograft is removed.
8. The area is irrigated and checked for bleeding.
9. Any instruments are removed.
10. The incision is closed.

4. Qualifying circumstances

CPT 48556 is performed when a previously transplanted donor pancreas fails to function normally. The patient must have undergone a prior pancreas transplant surgery. The procedure is typically performed when the patient’s condition worsens or complications arise from the transplanted pancreas. The provider must assess the patient’s condition and determine the need for removal of the transplanted pancreas.

5. When to use CPT code 48556

CPT code 48556 should be used when a provider performs the removal of a previously transplanted donor pancreas due to its failure to function normally. This code should not be used for other procedures or conditions unrelated to the removal of a transplanted pancreas.

6. Documentation requirements

To support a claim for CPT 48556, the provider must document the following information:

• Patient’s medical history and indication for the removal of the transplanted pancreas
• Details of the procedure, including the incision site, dissection, detachment of the pancreatic allograft, ligation of blood vessels, and closure of the incision
• Any complications or findings during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 48556, ensure that the procedure performed is the removal of a previously transplanted donor pancreas. This code should not be reported with modifier 22, as it already includes the complexity of removing a transplanted pancreas. Follow the appropriate coding guidelines and ensure accurate documentation to support the claim.

8. Historical information

CPT 48556 was added to the Current Procedural Terminology system on January 1, 1994. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient who previously underwent a pancreas transplant develops complications, and the provider performs CPT 48556 to remove the transplanted pancreas.
2. After a failed transplanted pancreas, the provider performs CPT 48556 to remove the non-functioning organ in a patient.
3. A patient experiences rejection of a transplanted pancreas, leading to its failure, and the provider performs CPT 48556 to remove the pancreas.
4. Due to infection and complications, the provider decides to remove a previously transplanted pancreas using CPT 48556.
5. A patient’s transplanted pancreas becomes necrotic, and the provider performs CPT 48556 to remove the non-viable organ.
6. Following a pancreas transplant, the patient experiences severe complications, and the provider decides to remove the transplanted pancreas using CPT 48556.
7. A patient’s transplanted pancreas fails to function properly, and the provider performs CPT 48556 to remove the non-functioning organ.
8. After a pancreas transplant, the patient develops vascular complications, and the provider performs CPT 48556 to remove the transplanted pancreas.
9. A patient’s transplanted pancreas becomes infected, leading to its failure, and the provider performs CPT 48556 to remove the infected organ.
10. Due to chronic rejection, the provider decides to remove a previously transplanted pancreas using CPT 48556.