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Official Description

Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 47370 involves laparoscopic surgical ablation of one or more liver tumors using radiofrequency energy. This minimally invasive technique begins with the creation of a small incision near the umbilicus, through which a trocar is inserted to establish pneumoperitoneum, allowing for the inflation of the abdominal cavity. Additional incisions are made in the upper and lower quadrants of the abdomen to facilitate the insertion of more trocars, which provide access for surgical instruments and visualization. The surgeon inspects the abdominal cavity for any extrahepatic tumors or abnormalities and addresses any adhesions through blunt and sharp dissection. The liver is then mobilized, and all eight hepatic segments are thoroughly examined to locate the tumors. In this procedure, ultrasound imaging, which is reported separately, is utilized to guide the placement of a radiofrequency needle electrode directly into the center of each tumor. The radiofrequency energy is applied to heat the tumor to a specific temperature, which is maintained for a predetermined duration to ensure effective ablation. After the heating cycle, the tissue is allowed to cool while the surgical team monitors the site to confirm that the entire tumor, along with a margin of healthy tissue, has been adequately destroyed. The electrode may be repositioned within the tumor to ensure complete necrosis. This process is repeated for any additional tumors present until all targeted tumors have been successfully ablated. The procedure concludes with the release of gas from the abdomen, removal of the laparoscope and surgical instruments, and closure of the portal incisions.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The laparoscopic surgical ablation of liver tumors using radiofrequency energy, as described by CPT® Code 47370, is indicated for the treatment of one or more liver tumors. The specific indications for this procedure include:

  • Liver Tumors The presence of one or more tumors located within the liver that require ablation.
  • Localized Tumors Tumors that are localized and can be effectively targeted for ablation without affecting surrounding healthy tissue.
  • Non-resectable Tumors Tumors that are deemed non-resectable due to their size, location, or the patient's overall health status.

2. Procedure

The procedure for laparoscopic surgical ablation of liver tumors using radiofrequency energy involves several key steps, which are detailed as follows:

  • Step 1: Incision and Trocar Insertion A small incision is made near the umbilicus to insert a trocar, which allows for the establishment of pneumoperitoneum. This inflation of the abdominal cavity is essential for creating a working space for the procedure. Additional incisions are made in the upper and lower quadrants of the abdomen, and more trocars are placed to facilitate access to the liver.
  • Step 2: Abdominal Inspection The surgeon inspects the abdominal cavity for any extrahepatic tumors or abnormalities. This step is crucial for assessing the overall condition of the liver and surrounding structures. Any adhesions found are lysed using both blunt and sharp dissection techniques to ensure clear access to the liver.
  • Step 3: Liver Mobilization and Tumor Identification The liver is mobilized, and all eight hepatic segments are inspected. The surgeon locates the tumors within the liver, preparing for the ablation process.
  • Step 4: Radiofrequency Electrode Placement Using separately reportable ultrasound imaging, the radiofrequency needle electrode is precisely placed in the center of each tumor. This imaging guidance is critical for accurate targeting of the tumors.
  • Step 5: Tumor Ablation Radiofrequency energy is applied to heat the tumor to the desired temperature, which is maintained for a specific duration. This heating process is designed to destroy the tumor while preserving surrounding healthy tissue.
  • Step 6: Monitoring and Repositioning After the heating cycle, the tissue is allowed to cool. The surgical team monitors the site to ensure complete destruction of the tumor and a margin of healthy tissue. The electrode may be removed and reinserted at different angles or locations within the tumor to ensure thorough necrosis.
  • Step 7: Repeat for Additional Tumors If multiple tumors are present, the above steps are repeated for each tumor until all have been successfully ablated.
  • Step 8: Conclusion of Procedure Following the completion of the ablation, gas is released from the abdomen, and the laparoscope along with surgical tools are removed. Finally, the portal incisions are closed to complete the procedure.

3. Post-Procedure

After the laparoscopic surgical ablation of liver tumors, patients are typically monitored for any immediate complications. Post-procedure care may include pain management and observation for signs of bleeding or infection. Patients are advised on activity restrictions and follow-up appointments to assess recovery and monitor liver function. The expected recovery time may vary based on individual patient factors and the extent of the procedure performed. It is essential for healthcare providers to provide clear instructions regarding post-operative care and any necessary lifestyle modifications to support healing.

Short Descr LAPARO ABLATE LIVER TUMOR RF
Medium Descr LAPS SURG ABLTJ 1/> LVR TUM RF
Long Descr Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency
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 Hospital Part B services paid through a comprehensive APC
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 99 - Other OR gastrointestinal therapeutic procedures

This is a primary code that can be used with these additional add-on codes.

49327 Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure)
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).
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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.
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.
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.)
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).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2010-01-01 Changed Code description changed.
2002-01-01 Added First appearance in code book in 2002.
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