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The procedure described by CPT® Code 47140 refers to a donor hepatectomy, specifically the surgical removal of the left lateral segment of the liver, which includes segments II and III, from a living donor. This operation is performed to procure liver tissue for transplantation. The term "hepatectomy" denotes the surgical excision of liver tissue, and in this case, it is conducted on a living donor, meaning that the donor is alive and voluntarily undergoing the procedure to provide a portion of their liver for another individual in need of a transplant. The removed liver segment is then subjected to cold preservation, a technique that involves cooling the liver tissue to prolong its viability for transplantation. During the procedure, a midline incision is typically made, extending from the substernal notch down to the pubis, although an upper midline approach may also be utilized depending on the surgeon's preference and the specific anatomy of the donor. The surgical team carefully exposes and inspects the liver to ensure proper access to the left lateral segment. The mobilization of this segment involves the division of several ligaments that support the liver, allowing for its displacement and the exposure of critical vascular structures. The meticulous dissection of the left branch of the portal vein, the left hepatic duct, and the left branch of the hepatic artery is essential for the safe removal of the liver segment. Following the separation of the liver parenchyma, the hepatic vein is double ligated and transected, completing the excision of the left lateral segment. The segment is then perfused with a cold preservation solution to maintain its integrity until it can be transplanted into the recipient. The procedure concludes with the control of any bleeding, irrigation of the wound, and closure around drains to facilitate recovery.
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The donor hepatectomy procedure, as described by CPT® Code 47140, is indicated for specific clinical scenarios where a living donor is required to provide a portion of their liver for transplantation. The following conditions may warrant this procedure:
The donor hepatectomy procedure involves several critical steps to ensure the safe and effective removal of the left lateral segment of the liver. The following outlines the procedural steps involved:
Post-procedure care following a donor hepatectomy involves monitoring the donor for any complications, managing pain, and ensuring proper recovery. The donor will typically be observed in a postoperative setting where vital signs are closely monitored. The surgical site will be assessed for signs of infection or excessive bleeding. The presence of drains is common to help remove any excess fluid that may accumulate in the surgical area. Recovery time may vary, but donors are generally expected to stay in the hospital for several days for observation and management of any postoperative issues. Follow-up appointments will be scheduled to monitor the donor's liver function and overall health as they recover from the surgery.
| Short Descr | PARTIAL REMOVAL DONOR LIVER | Medium Descr | DONOR HEPATECTOMY LIVING DONOR SEG II & III | Long Descr | Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 2 - Team surgeons permitted; pay by report. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 176 - Other organ transplantation |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q3 | Live kidney donor surgery and related services |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2005-01-01 | Changed | Code description changed. |
| 2004-01-01 | Added | First appearance in code book in 2004. |
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