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need help/ 2nd time posting!

  1. #1
    Default need help/ 2nd time posting!
    Clearnace Sale
    I posted this in an earlier thred but did not receive any replies so I am reposting it hoping someone may be able to help...

    This report was performed by Dr. YYYYY (which is one of our IR doctors and Dr.XXXXX who is not in our practice and I can not see his reports)

    ERCP -:

    INDICATION: Suspected biliary obstruction and history of cholecystectomy
    with indwelling T-tube.

    Through existing T-tube under sterile conditions, contrast was
    administered after written informed consent was obtained. T-tube
    cholangiographic images showed fairly rapid spill of contrast from the
    nondilated common hepatic and common bile duct on into the duodenum
    through the ampulla with reflux of contrast into the pancreatic duct

    Next, a Glidewire was utilized placed through existing T-tube and this
    Glidewire was used to traverse on into the small bowel through the
    ampulla. Next, Kumpe catheter was inserted over the Glidewire and there
    was exchange for a 450.0 cm guidewire. ET tube been removed, the
    guidewire was secured to the patient's skin and the patient is placed in
    the upright position for ERCP subsequently performed by Dr. XXXX. ERCP
    images obtained show no evidence of filling defect to suggest a retained
    stone in the common bile duct. At the conclusion of ERCP, a 10-French
    5.0 cm internal plastic biliary stent was placed to allow drainage. A
    sphincterotomy was also performed.

    Please see Dr. XXXX's ERCP report.

    IMPRESSION: Combined procedure with Dr. XXXX. The T-tube cholangiogram
    was performed showing no definite stone or obstruction as suggested by
    previous cholangiograms. It is therefore presumed that the degree of
    obstruction seen previously was actually likely edema related.

    Wire passage was performed to assist Dr. XXXX for access with ERCP.

    Internal biliary stent was placed for preventive purposes.

    This is what I have so far...



    I have not checked th CCI edits yet. I am not sure how I should code the catheter that was placed.

    Thanks for your help in advance!

  2. #2
    Default biliary stent
    I would prefer the following codes:

    47505 (T tube cholangiogram)
    74305-26 (S&I for 47505)
    74328-26 (ERCP)
    47556 (Biliary structure dilatation with stent Via T-tube)
    74363-26 (S&I for 47556)

    The CPT 47801 may not be used since, it is a open procedure.

    Hope this helps !

    Abdul Saleem CPC

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