General Surgery Coding Alert

Reader Questions:

Cholangiogram Isn't Separate With Exploration

Question: If the surgeon performs both cholangiography and exploration of the common bile duct (to locate and remove gallstone), may I report both 47610 and 47605?

West Virginia Subscriber

Answer: No. In this case, you should report only 47610 (Cholecystectomy with exploration of common duct).

Here's why: The national Correct Coding Initiative (CCI) bundles cholangiography, 47605 (Cholecystectomy; with cholangiography), to exploration 47610 and likewise bundles 47563 (Laparoscopy, surgical; cholecystectomy with cholangiography) into 47564 (Laparoscopy, surgical; cholecystectomy with exploration of common duct) for a laparoscopic approach. Both edits include a "0" modifier indicator, meaning that you may never override them.

In other words: Payers will always include the work involved in cholangiography in exploration of the common ducts.