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CPT®
43271

CPT® Code 43271
Deleted

Code deleted, see 43277

Official Description

Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde balloon dilation of ampulla, biliary and/or pancreatic duct(s)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions affecting the biliary and pancreatic ducts. This procedure is particularly focused on the Ampulla of Vater, which is the anatomical site where the pancreatic duct and the common bile duct converge in the duodenum. During ERCP, an endoscope—a flexible tube equipped with a camera and light—is inserted through the mouth, advancing through the esophagus and stomach, and into the duodenum. The goal is to reach the Ampulla of Vater, where a smaller catheter is introduced through the endoscope. This catheter is used to cannulate the Ampulla of Vater, allowing for the injection of contrast dye into the biliary and pancreatic ducts. The introduction of contrast dye is crucial as it enables visualization of the ducts on x-ray images, helping to identify any obstructions, strictures, or other abnormalities. In cases where there is a narrowing of the duct (stricture), a balloon catheter is utilized. This catheter is advanced over a guidewire to the site of the stricture, where it is inflated to dilate the narrowed area, thereby facilitating improved flow through the ducts. This combination of diagnostic and therapeutic techniques makes ERCP a valuable procedure in managing various biliary and pancreatic disorders.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Endoscopic retrograde cholangiopancreatography (ERCP) with balloon dilation is indicated for several specific conditions related to the biliary and pancreatic systems. These indications include:

  • Strictures of the Biliary Ducts - This procedure is performed to address narrowing in the biliary ducts, which can impede the flow of bile and lead to complications such as jaundice or cholangitis.
  • Strictures of the Pancreatic Ducts - ERCP is indicated for the treatment of strictures in the pancreatic duct, which can affect pancreatic function and lead to pancreatitis.
  • Obstructive Jaundice - Patients presenting with obstructive jaundice due to stones or strictures in the biliary system may require ERCP for diagnosis and potential therapeutic intervention.
  • Cholangiocarcinoma - In cases where there is suspicion of bile duct cancer, ERCP can be utilized for diagnostic purposes and to relieve biliary obstruction.

2. Procedure

The procedure of endoscopic retrograde cholangiopancreatography (ERCP) with balloon dilation involves several critical steps to ensure effective diagnosis and treatment. The following outlines the procedural steps:

  • Step 1: Patient Preparation - Prior to the procedure, the patient is typically required to fast for several hours. Sedation is administered to ensure comfort during the procedure, and vital signs are monitored closely.
  • Step 2: Endoscope Insertion - The endoscope is carefully inserted through the patient's mouth and advanced through the esophagus and stomach into the duodenum. The endoscope allows visualization of the gastrointestinal tract and the Ampulla of Vater.
  • Step 3: Cannulation of the Ampulla of Vater - Once the endoscope reaches the duodenum, a smaller catheter is introduced through the endoscope. The Ampulla of Vater is cannulated, allowing access to the biliary and pancreatic ducts.
  • Step 4: Contrast Injection - Contrast dye is injected through the catheter into the biliary and pancreatic ducts. This step is crucial for visualizing the ducts on x-ray images, helping to identify any obstructions or abnormalities.
  • Step 5: Imaging - X-ray images are taken immediately after the contrast dye is injected. These images provide valuable information regarding the anatomy and any pathological conditions present in the biliary and pancreatic systems.
  • Step 6: Balloon Dilation - If a stricture is identified, a balloon catheter is advanced over a guidewire to the site of the narrowing. The balloon is then inflated to dilate the stricture, which helps restore normal flow through the affected duct.
  • Step 7: Post-Procedure Care - After the procedure, the patient is monitored as the sedation wears off. Instructions regarding diet and activity may be provided, along with information on potential post-procedure symptoms to watch for.

3. Post-Procedure

Following the endoscopic retrograde cholangiopancreatography (ERCP) with balloon dilation, patients are typically observed in a recovery area until the effects of sedation have diminished. It is common for patients to experience mild discomfort, such as a sore throat or abdominal cramping, which usually resolves within a short period. Patients may be advised to start with clear liquids and gradually progress to a regular diet as tolerated. It is important for patients to be informed about potential complications, such as pancreatitis, infection, or bleeding, and to report any unusual symptoms, such as severe abdominal pain, fever, or jaundice, to their healthcare provider promptly. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to monitor for any recurrence of symptoms.
Short Descr ENDO CHOLANGIOPANCREATOGRAPH
Medium Descr ERCP W/BALO DILAT AMPULLA BILIARY&/PNCRTC DUX
Long Descr Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde balloon dilation of ampulla, biliary and/or pancreatic duct(s)
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special rules for multiple endoscopic procedures apply...
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 43260  Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8B - Endoscopy - upper gastrointestinal
MUE Not applicable/unspecified.
CCS Clinical Classification 82 - Endoscopic retrograde cannulation of pancreas (ERCP)
Date
Action
Notes
2014-01-01 Deleted Code deleted, see 43277
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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