© Copyright 2025 American Medical Association. All rights reserved.
Transduodenal sphincterotomy or sphincteroplasty, as described by CPT® Code 47460, refers to a surgical procedure aimed at addressing dysfunctions of the sphincter of Oddi, which is a critical anatomical structure located at the junction where the pancreatic and bile ducts enter the duodenum. This sphincter functions as a one-way valve, facilitating the flow of bile into the duodenum while simultaneously preventing the reverse flow of intestinal contents into the bile ducts. When there is a presence of a stricture or a calculus (stone) within this area, it can lead to significant complications such as pancreatitis, biliary dilatation, and associated pain due to impaired bile drainage. The procedure can be performed either through an extraperitoneal approach, which involves a flank incision, or via an intraperitoneal approach through an abdominal incision. During the operation, the second part of the duodenum is accessed and incised to expose the sphincter of Oddi. The surgeon then identifies and divides the sphincter, extending the incision to the dilated portion of the bile duct to facilitate the removal of any obstructive stones. Following the removal of the stones, the common bile duct and duodenum are sutured together to restore continuity and function.
© Copyright 2025 Coding Ahead. All rights reserved.
The transduodenal sphincterotomy or sphincteroplasty procedure is indicated for specific conditions related to the dysfunction of the sphincter of Oddi. These indications include:
The procedure for transduodenal sphincterotomy or sphincteroplasty involves several critical steps, which are detailed as follows:
Post-procedure care for patients undergoing transduodenal sphincterotomy or sphincteroplasty typically involves monitoring for any complications such as infection, bleeding, or pancreatitis. Patients may require a period of hospitalization for observation and management of pain. Recovery time can vary, but patients are generally advised to follow a specific diet and gradually resume normal activities as tolerated. Follow-up appointments are essential to assess the success of the procedure and to monitor for any recurrence of symptoms or complications.
| Short Descr | INCISE BILE DUCT SPHINCTER | Medium Descr | TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS | Long Descr | Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure) | 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 |
| 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). | 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 |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.