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CPT® Code 47700 refers to the surgical procedure known as exploration for congenital atresia of the bile ducts, which is performed without repair. This procedure may also include a liver biopsy and/or cholangiography, depending on the clinical scenario. Congenital biliary atresia is a serious condition characterized by the obliteration or discontinuity of the extrahepatic bile ducts, leading to an obstruction in the flow of bile from the liver. If left untreated, this condition can progress to severe liver damage, including cirrhosis and eventual liver failure. During the procedure, an abdominal incision is made in the upper midline to expose the gallbladder and liver. The surgeon identifies the extrahepatic bile ducts or any remnants of the biliary tract and assesses their patency. Intraoperative cholangiography may be performed by inserting a small catheter into the cystic duct and injecting contrast media to visualize the anatomy of the biliary tree radiographically. The successful passage of contrast media to the gastrointestinal tract indicates normal biliary function, while failure to do so suggests biliary atresia. Additionally, tissue samples may be collected from the liver for histological evaluation to check for signs of bile duct proliferation or obstruction, which are critical for determining the appropriate management of the condition.
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The procedure coded as CPT® 47700 is indicated for the evaluation of congenital biliary atresia, which is characterized by the following conditions:
The exploration for congenital atresia of the bile ducts involves several critical procedural steps:
After the exploration for congenital atresia of the bile ducts, the patient is monitored for any complications related to the procedure. Post-operative care may include pain management, monitoring for signs of infection, and assessing liver function. The recovery period will vary depending on the extent of the procedure and the patient's overall health. Follow-up appointments are essential to evaluate the patient's progress and to discuss any further management options based on the findings from the procedure.
| Short Descr | EXPLORATION OF BILE DUCTS | Medium Descr | EXPL CONGENITAL ATRESIA BILE DUCTS | Long Descr | Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography | 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 | 97 - Other gastrointestinal diagnostic procedures |
| 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). | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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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