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The procedure described by CPT® Code 47400 refers to a hepaticotomy or hepaticostomy, which involves surgical intervention on the liver. This procedure is performed through a midline abdominal incision that allows the surgeon to gain access to the liver. The falciform ligament, which is a fold of peritoneum that connects the liver to the anterior abdominal wall, is divided to facilitate exposure. Once the liver is accessible, the overlying bowel is retracted to provide a clear view of the liver. The right and left peritoneal ligaments are incised, and the right and left triangular ligaments are excised to further mobilize the liver for inspection. During this exploration, the surgeon looks for any signs of disease and assesses the condition of the liver and its associated structures. If an obstructed duct, either extrahepatic or intrahepatic, is identified, it is incised to allow for the drainage of bile. In cases where an intrahepatic calculus, or stone, is present, it is removed during this procedure. After addressing the issues with the duct, the incision may either be closed or a drain may be placed to facilitate further drainage. Finally, the abdominal incision is closed in layers to ensure proper healing and recovery.
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The procedure associated with CPT® Code 47400 is indicated for specific conditions related to the liver and biliary system. These indications include:
The procedure involves several critical steps to ensure effective access and treatment of the liver and biliary system. These steps include:
Post-procedure care following a hepaticotomy or hepaticostomy involves monitoring the patient for any signs of complications, such as infection or bleeding. Patients may require pain management and should be observed for any changes in liver function or bile drainage. If a drain has been placed, it will need to be monitored and managed appropriately. The recovery process may vary depending on the extent of the procedure and the patient's overall health, but careful follow-up is essential to ensure proper healing and to address any potential issues that may arise.
| Short Descr | INCISION OF LIVER DUCT | Medium Descr | HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1 | Long Descr | Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus | 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 | 84 - Cholecystectomy and common duct exploration |
| 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). | 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.) | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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