© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 47146 involves the backbench reconstruction of a liver graft, which can be sourced from either a cadaver or a living donor, prior to its transplantation into a recipient. This intricate surgical process is essential for ensuring that any anatomical variations in the venous or arterial blood supply to the donor liver are properly identified and reconstructed. During this back table procedure, the hepatic venous drainage is meticulously inspected, allowing the surgical team to correct any anatomical anomalies by reconstructing and anastomosing the abnormal vessels to the hepatic venous drainage system. The common hepatic artery, which is one of the three branches of the celiac artery, typically serves as the primary blood supply to the liver. However, it is important to note that the liver may also receive blood supply from the other two branches of the celiac artery, namely the splenic and gastric arteries, or even from the superior mesenteric artery. These alternative arterial sources are preserved during the procedure and are revascularized by connecting them to the main hepatic circulation. For accurate coding, the CPT® Code 47146 should be utilized for each venous anastomosis performed during this reconstruction process, while CPT® Code 47147 is designated for each arterial anastomosis that may be necessary.
© Copyright 2025 Coding Ahead. All rights reserved.
The backbench reconstruction of a liver graft is indicated in cases where there are anatomical variations in the venous or arterial blood supply to the donor liver. This procedure is essential prior to transplantation to ensure proper blood flow and function of the liver once it is implanted into the recipient. Specific indications may include:
The procedure for backbench reconstruction of a liver graft involves several critical steps to ensure the graft is adequately prepared for transplantation. Each step is essential for the successful anastomosis of the venous structures.
Post-procedure care following the backbench reconstruction of a liver graft involves monitoring the graft for proper function and ensuring that there are no complications related to the anastomosis. The surgical team will typically assess the blood flow to the liver and monitor for any signs of rejection or complications. Additionally, the recipient will require careful management and follow-up to ensure the success of the transplantation and the overall health of the graft. Regular imaging studies may be performed to evaluate the patency of the anastomoses and the function of the liver graft in the postoperative period.
| Short Descr | PREP DONOR LIVER/VENOUS | Medium Descr | BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA | Long Descr | Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | 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 | 2 | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2005-01-01 | Added | First appearance in code book in 2005. |
Get instant expert-level medical coding assistance.