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The CPT® Code 47362 refers to the management of liver hemorrhage through the re-exploration of a hepatic wound for the removal of packing. This procedure is typically indicated when there has been significant bleeding from the liver, necessitating surgical intervention to control the hemorrhage. The process begins with a midline abdominal incision, which allows the surgeon to gain access to the liver and the surrounding abdominal cavity. During this exploration, the surgeon assesses the extent of the liver injury and checks for any potential damage to adjacent organs, blood vessels, or nerves. The falciform ligament is divided to facilitate access, and the overlying bowel is retracted to provide a clear view of the liver. To adequately expose the liver, the right and left peritoneal ligaments are incised, and the triangular ligaments are excised. This mobilization of the liver is crucial for a thorough examination and treatment of the hepatic injury. The procedure may involve various techniques for repairing liver wounds, including simple or complex suturing, ligation of intrahepatic blood vessels and bile ducts, and the use of hemostatic agents to control bleeding. If bleeding persists after initial repair efforts, a selective hepatic artery ligation may be performed. In cases where packing has been used to control bleeding, the abdomen is re-opened one to two days post-repair to remove the packing and inspect the liver for any signs of ongoing bleeding or necrosis. This re-exploration is critical for ensuring that the liver is healing properly and that any additional debridement can be performed if necessary. The abdomen is then closed in layers, ensuring proper healing and recovery.
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The procedure associated with CPT® Code 47362 is indicated for the management of liver hemorrhage. Specific indications for performing this procedure include:
The procedure for CPT® Code 47362 involves several critical steps to ensure effective management of liver hemorrhage:
Post-procedure care following the management of liver hemorrhage with CPT® Code 47362 involves careful monitoring of the patient for signs of complications, such as continued bleeding or infection. The patient may require supportive care, including fluid management and pain control. The surgical site should be observed for any signs of necrosis or delayed healing. Follow-up imaging may be necessary to assess the liver's condition and ensure that there are no further complications. The abdomen is closed in layers to promote proper healing, and the patient will be monitored in a clinical setting for a period of time to ensure stability and recovery.
| Short Descr | REPAIR LIVER WOUND | Medium Descr | MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING | Long Descr | Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing | 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) | 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 | 99 - Other OR gastrointestinal therapeutic procedures |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | SG | Ambulatory surgical center (asc) facility service |
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| 1996-01-01 | Added | First appearance in code book in 1996. |
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