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The CPT® Code 47712 refers to the excision of a tumor located in the intrahepatic bile duct, which is the segment of the bile duct situated within the liver. Bile duct tumors are relatively uncommon and can be classified as either benign or malignant, with malignant tumors being more prevalent. The distinction between intrahepatic and extrahepatic bile duct tumors is significant; extrahepatic tumors occur outside the liver, while intrahepatic tumors are found within the liver itself. Due to the higher likelihood of malignancy and the potential for metastasis associated with intrahepatic bile duct tumors, local excision is not frequently performed. When this procedure is indicated, it involves making a midline abdominal incision to access the gallbladder and liver, allowing for the identification of the bile duct tumor. The surgical approach includes transecting the bile duct both above and below the tumor, followed by the excision of the tumor along with the affected bile duct segment. After excision, the bile duct may be repaired by suturing the remaining ductal ends together or through alternative reconstruction techniques, such as a Roux-en-Y hepaticojejunostomy, which may be reported separately. It is important to note that CPT® Code 47711 is designated for the excision of extrahepatic bile duct tumors, while CPT® Code 47712 specifically pertains to intrahepatic bile duct tumors.
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The procedure described by CPT® Code 47712 is indicated for the excision of tumors located within the intrahepatic bile duct. The following conditions may warrant this surgical intervention:
The procedure for excising an intrahepatic bile duct tumor involves several critical steps, which are outlined as follows:
Post-procedure care following the excision of an intrahepatic bile duct tumor typically involves monitoring the patient for complications such as bleeding, infection, or bile leakage. Patients may require supportive care, including pain management and fluid replacement. The recovery period can vary based on the extent of the surgery and the patient's overall health. Follow-up imaging studies may be necessary to assess for any recurrence of the tumor or complications related to the bile duct repair. Additionally, patients may need to be monitored for signs of jaundice or other symptoms indicating bile duct obstruction.
| Short Descr | EXCISION OF BILE DUCT TUMOR | Medium Descr | EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC | Long Descr | Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic | 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 | 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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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| 1995-01-01 | Added | First appearance in code book in 1995. |
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