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The procedure described by CPT® Code 47144 involves the meticulous preparation of a cadaver donor's whole liver graft prior to its transplantation into a recipient. This process is commonly referred to as backbench or back table preparation. During this procedure, the liver may be received with or without the gallbladder attached. If the gallbladder is present, a cholecystectomy, or gallbladder removal, is performed as part of the preparation. The surrounding soft tissues are carefully dissected away to expose critical vascular structures, including the vena cava, portal vein, hepatic artery, and common bile duct, which are essential for successful implantation into the recipient. The preparation also includes the trisegment split of the whole liver graft into two partial liver grafts: the left lateral segment, which comprises segments II and III, and the right trisegment, which includes segments I and IV through VIII. This splitting technique allows for the potential transplantation of liver segments into two different patients, thereby maximizing the utility of the donor organ. The procedure is complex and requires precise surgical techniques to ensure that all vascular and biliary structures are adequately prepared for transplantation, which is critical for the success of the procedure and the health of the transplant recipients.
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The backbench standard preparation of a cadaver donor whole liver graft, as described by CPT® Code 47144, is indicated for the following conditions:
The procedure for backbench preparation of the liver graft involves several critical steps:
After the backbench preparation of the liver graft, the organ is ready for transplantation. The expected recovery involves monitoring for any complications related to the preparation process, such as bleeding or vascular issues. The graft must be handled with care to maintain its viability until implantation. Additionally, any anomalies identified during the dissection may require further surgical intervention during the transplantation procedure. Proper documentation of the preparation steps and any findings is essential for compliance and future reference.
| Short Descr | PREP DONOR LIVER 3-SEGMENT | Medium Descr | BKBENCH PREPJ CADAVER WHOLE LIVER GRF I&IV VII | Long Descr | Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegment split of whole liver graft into 2 partial liver grafts (ie, left lateral segment [segments II and III] and right trisegment [segments I and IV through VIII]) | Status Code | Carriers Price the 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) | 0 - Team surgeons not permitted for this procedure. | 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). | 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. |
| 2010-01-01 | Changed | Code description changed. |
| 2009-01-01 | Changed | Code description changed |
| 2005-01-01 | Added | First appearance in code book in 2005. |
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