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The CPT® Code 47560 refers to a laparoscopic surgical procedure that involves guided transhepatic cholangiography without the inclusion of a biopsy. This procedure is performed through small incisions in the abdomen, allowing for minimal invasiveness. The laparoscope, which is a thin tube equipped with a camera, is inserted to provide visual access to the abdominal cavity, specifically targeting the liver, gallbladder, and biliary tract. The abdomen is inflated with carbon dioxide to create a working space for the surgeon. During the procedure, a needle is carefully inserted through the liver into the bile duct under continuous laparoscopic guidance. A contrast medium is then injected to confirm the needle's placement within the bile duct, allowing for the visualization of the bile ducts through the subsequent injection of contrast media via an angiography catheter. It is important to note that this code specifically excludes any biopsy procedures, which are reported separately under CPT® Code 47561, where tissue samples are obtained for laboratory analysis. The focus of CPT® Code 47560 is solely on the laparoscopic guidance, catheter placement, and contrast injection necessary for the cholangiography, emphasizing the procedural aspects without the additional complexity of biopsy collection.
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The procedure described by CPT® Code 47560 is indicated for various clinical scenarios where visualization of the biliary tract is necessary. The following conditions may warrant the performance of this procedure:
The procedure begins with the patient being placed under general anesthesia to ensure comfort and immobility during the operation. Following this, a small portal incision is made near the umbilicus, which serves as the primary access point. A laparoscope, equipped with a video camera, is then inserted through this incision. To facilitate the procedure, the abdomen is inflated with carbon dioxide, creating a working space that allows for better visualization and access to the internal organs. Subsequently, two or three additional portal incisions are made in the upper abdomen, through which trocars are inserted. These trocars serve as access ports for the surgical instruments needed during the procedure.
Once the laparoscope is in place, the surgeon inspects the abdominal cavity, focusing on the liver, gallbladder, and biliary tract. Utilizing continuous laparoscopic guidance, a needle is carefully inserted through one of the trocars and advanced through the liver into the bile duct. A small amount of contrast media is then injected through the needle to confirm its correct placement within the bile duct. After confirming the position, a guidewire is passed through the needle into the bile duct, and the needle is subsequently removed. An angiography catheter is then advanced over the guidewire into the bile duct, allowing for the guidewire to be removed. Finally, contrast media is injected through the catheter, enabling visualization of the bile ducts on imaging studies. It is crucial to note that this procedure focuses solely on the laparoscopic guidance, catheter placement, and contrast injection, while the radiological component of the cholangiogram is reported separately.
After the completion of the procedure, the patient is typically monitored in a recovery area until the effects of anesthesia wear off. Post-procedure care may include pain management and monitoring for any potential complications, such as bleeding or infection at the incision sites. Patients are usually advised to follow specific post-operative instructions, which may include restrictions on physical activity and dietary modifications. The expected recovery time can vary, but many patients are able to resume normal activities within a few days, depending on their overall health and the complexity of the procedure. Follow-up appointments may be scheduled to assess recovery and discuss any further necessary interventions based on the findings from the cholangiography.
| Short Descr | LAPAROSCOPY W/CHOLANGIO | Medium Descr | LAPS SURG W/GID TRANSHEPATC CHOLANGRPH W/O BX | Long Descr | Laparoscopy, surgical; with guided transhepatic cholangiography, without biopsy | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 97 - Other gastrointestinal diagnostic procedures |
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| 2016-01-01 | Deleted | Code deleted, to report see 47579 |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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