eswaranpandiyaraj
Contributor
What is the CPT Code for the below ERCP Procedure,
The Scout film was normal , the esophagus was successfully intubated under direct vision. The scope was advanced to a normal major papilla in the descending duodenum without detailed examination of the pharynx, larynx and associated structures and upper GI tract. The Upper GI tract was grossly normal. A short 0.025 inch Jagwire was passed in to the biliary tree. The Jagtome sphincterotome was passed over the guidewire and the bile duct was then deeply cannulated. Contrast was injected. I personally interpreted the bile duct images. Ductal flow of contrast was adequate. Image quality was adequate. Contrast extended to the entire biliary tree. The lower third of the main bile duct contained one stone, which was 4 mm in diameter. A 7 mm biliary sphincterotomy was made with a monofilament . Jagtome sphincterotome using ERBE electrocautery . There was no post - sphincterotomy bleeding. Dilation of the common bile duct with an 8 mm balloon dilator was successful. The biliary tree was swept with an 8.5 mm balloon and 11.5 mm balloon starting at the right intrahepatic ducts. One stone was removed . No stones remained. Final balloon sweep revealed one bile. Occlusion cholangiogram revealed no residual filling defects
Impression :
Duodenal diverticulum noted
Cholangiogram revealed a mildly dilated CBD to 8-9 mm and a distal filling defect
8 mm sphincterotomy with sphincteroplasty was performed
Balloon sweep revealed one stone, final balloon sweep revealed one bile
.
The Scout film was normal , the esophagus was successfully intubated under direct vision. The scope was advanced to a normal major papilla in the descending duodenum without detailed examination of the pharynx, larynx and associated structures and upper GI tract. The Upper GI tract was grossly normal. A short 0.025 inch Jagwire was passed in to the biliary tree. The Jagtome sphincterotome was passed over the guidewire and the bile duct was then deeply cannulated. Contrast was injected. I personally interpreted the bile duct images. Ductal flow of contrast was adequate. Image quality was adequate. Contrast extended to the entire biliary tree. The lower third of the main bile duct contained one stone, which was 4 mm in diameter. A 7 mm biliary sphincterotomy was made with a monofilament . Jagtome sphincterotome using ERBE electrocautery . There was no post - sphincterotomy bleeding. Dilation of the common bile duct with an 8 mm balloon dilator was successful. The biliary tree was swept with an 8.5 mm balloon and 11.5 mm balloon starting at the right intrahepatic ducts. One stone was removed . No stones remained. Final balloon sweep revealed one bile. Occlusion cholangiogram revealed no residual filling defects
Impression :
Duodenal diverticulum noted
Cholangiogram revealed a mildly dilated CBD to 8-9 mm and a distal filling defect
8 mm sphincterotomy with sphincteroplasty was performed
Balloon sweep revealed one stone, final balloon sweep revealed one bile
.