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The procedure described by CPT® Code 47141 refers to a donor hepatectomy, specifically a total left lobectomy, which involves the surgical removal of the left lateral segment of the liver from a living donor. This procedure is performed to obtain liver tissue for transplantation, where the removed segment is preserved using cold preservation techniques to maintain its viability until it can be transplanted into a recipient. The left lateral segment comprises segments II, III, and IV of the liver, which are critical for the function of the organ. The surgical approach typically involves a midline incision that extends 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 circumstances of the donor's anatomy. During the operation, the liver is carefully exposed and inspected to assess its condition. The left lateral segment is mobilized by cutting through several ligaments, including the left triangular, left coronary, and falciform ligaments, which support the liver. Once mobilized, the segment is displaced downward to allow access to the porta hepatis, where important vascular structures are located. The surgeon meticulously dissects and occludes the tributaries of the left branch of the portal vein, the left hepatic duct, and the left branch of the hepatic artery to ensure that the segment can be safely removed without compromising the donor's remaining liver function. The liver parenchyma is then separated down to the level of the hepatic vein, which is double ligated and transected to complete the removal of the segment. After excision, the liver segment is perfused with a cold preservation solution to prepare it for transplantation. The donor's surgical site is managed by controlling any bleeding, irrigating the wound, and closing it around drains to facilitate recovery. This procedure is critical in the context of living donor liver transplantation, where the health and safety of the donor are paramount.
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The procedure of donor hepatectomy, specifically total left lobectomy, is indicated for the following conditions:
The donor hepatectomy procedure involves several critical steps to ensure the safe and effective removal of the left lateral segment of the liver.
Post-procedure care for the donor involves monitoring for any complications, managing pain, and ensuring proper wound healing. The donor will be observed for signs of bleeding or infection, and appropriate measures will be taken to address any issues that arise. Recovery time may vary, but the donor is typically expected to stay in the hospital for several days for observation and care. Follow-up appointments will be scheduled to assess the donor's recovery and liver function, ensuring that the remaining liver is functioning adequately after the removal of the left lateral segment.
| Short Descr | PARTIAL REMOVAL DONOR LIVER | Medium Descr | DONOR HEPATECTOMY LIVING DONOR SEG II III & IV | Long Descr | Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III and IV) | 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 |
| 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). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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 |
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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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