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The procedure described by CPT® Code 47554 involves a biliary endoscopy performed percutaneously through a T-tube or another tract. This minimally invasive technique utilizes a flexible fiberoptic endoscope, which is a specialized instrument designed to visualize the bile ducts. During the procedure, the endoscope is carefully inserted through the T-tube or an alternative access point, allowing the physician to inspect the bile ducts for any signs of disease or abnormalities. The primary goal of this procedure is to locate and remove calculi, which are solid particles that can obstruct the bile ducts and lead to complications such as cholangitis or pancreatitis. Once the calculus is identified, the physician employs specialized tools, such as a snare or basket, to capture and extract the stones. The procedure may also involve the use of a balloon catheter to facilitate the removal of larger calculi. After all calculi have been successfully extracted, the endoscope is withdrawn, and the biliary ducts are re-examined to ensure that no injury has occurred during the removal process. This comprehensive approach not only addresses the immediate issue of calculus removal but also helps in assessing the overall health of the biliary system.
© Copyright 2025 Coding Ahead. All rights reserved.
The biliary endoscopy procedure described by CPT® Code 47554 is indicated for the following conditions:
The biliary endoscopy procedure begins with the insertion of a flexible fiberoptic endoscope through the T-tube or another tract. This initial step allows the physician to gain access to the biliary system. Once the endoscope is in place, the bile ducts are thoroughly inspected for any signs of disease or abnormalities. The physician carefully advances the endoscope to the specific site where the calculus is located. At this point, a snare or basket is introduced through a separate channel in the endoscope. The snare or basket is manipulated to position it beyond the calculus, after which it is opened to capture the stone. Once the calculus is secured, it is extracted through the endoscope. In some cases, if the calculus is particularly large or difficult to remove, a balloon catheter may be utilized. The balloon is advanced beyond the calculus, inflated to dislodge the stone, and then the calculus is removed. This process may be repeated multiple times until all calculi have been successfully extracted. After the removal of the calculi, the endoscope is carefully withdrawn, and the biliary ducts are inspected once more to check for any signs of injury that may have occurred during the extraction process.
Post-procedure care following a biliary endoscopy with calculus removal typically involves monitoring the patient for any immediate complications, such as bleeding or infection. Patients may be observed for signs of biliary obstruction or pancreatitis, which can occur if any residual stones remain. It is essential to provide appropriate pain management and hydration as needed. The physician may also recommend follow-up imaging studies to ensure that the biliary system is clear of any remaining calculi and to assess the overall health of the bile ducts. Patients should be advised on signs and symptoms that warrant immediate medical attention, such as fever, jaundice, or severe abdominal pain, which could indicate complications. Overall, the recovery process is generally straightforward, but careful monitoring is crucial to ensure a successful outcome.
| Short Descr | BILIARY ENDOSCOPY THRU SKIN | Medium Descr | BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS | Long Descr | Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic 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) | 1 - Statutory payment restriction for assistants at surgery applies 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. | Endoscopic Base Code | 47552 Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - 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). | 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). | 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.) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 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 | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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