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Official Description

Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 47800 involves the surgical reconstruction of the extrahepatic biliary ducts, which are the ducts outside the liver that transport bile from the liver and gallbladder to the duodenum. This procedure is typically indicated when there is a disease or injury affecting these ducts, necessitating surgical intervention to restore normal bile flow. The operation begins with a midline abdominal incision, allowing access to the liver, gallbladder, and the extrahepatic bile ducts. Once the area is exposed, the surgeon identifies the specific segment of the bile duct that is diseased or injured. After evaluating the extent of the injury, the affected segment is excised, and the remaining healthy ends of the bile ducts are sutured together in an end-to-end anastomosis. This technique is crucial for re-establishing continuity within the biliary system. Following the reconstruction, the surgical site is irrigated to prevent infection, and drains may be placed to facilitate fluid removal. Finally, the abdominal incision is closed in layers to promote proper healing.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure is performed for specific indications related to the extrahepatic biliary ducts. These include:

  • Diseased Extrahepatic Bile Ducts The presence of conditions such as strictures, tumors, or other pathological changes that compromise the function of the bile ducts.
  • Injured Extrahepatic Bile Ducts Trauma or surgical complications that result in damage to the bile ducts, necessitating reconstruction to restore normal anatomy and function.

2. Procedure

The surgical procedure for CPT® Code 47800 involves several critical steps to ensure successful reconstruction of the extrahepatic biliary ducts.

  • Step 1: Abdominal Incision The procedure begins with the surgeon making a midline incision in the abdomen. This incision provides access to the liver, gallbladder, and the extrahepatic bile ducts, which are essential for the subsequent steps of the surgery.
  • Step 2: Exposure of Structures Once the incision is made, the surgeon carefully exposes the liver, gallbladder, and the extrahepatic bile ducts. This exposure is crucial for identifying the specific area of concern within the biliary system.
  • Step 3: Identification and Evaluation of Injury The surgeon identifies the diseased or injured segment of the extrahepatic bile duct. A thorough evaluation of the injury is performed to determine the extent of the damage and the appropriate surgical approach.
  • Step 4: Excision of the Affected Segment After evaluating the injury, the surgeon excises the diseased or injured segment of the bile duct. This step is vital to remove any pathological tissue that could impede normal bile flow.
  • Step 5: Anastomosis Following the excision, the remaining healthy ends of the bile ducts are sutured together in an end-to-end anastomosis. This technique restores continuity within the biliary system, allowing bile to flow normally from the liver to the duodenum.
  • Step 6: Irrigation and Drain Placement After the anastomosis is completed, the surgical wound is irrigated to reduce the risk of infection. Additionally, drains may be placed as needed to facilitate the removal of any excess fluid that may accumulate postoperatively.
  • Step 7: Closure of the Incision Finally, the abdominal incision is closed in layers. This layered closure technique is important for promoting proper healing and minimizing complications.

3. Post-Procedure

Post-procedure care following the reconstruction of the extrahepatic biliary ducts includes monitoring for any signs of complications, such as infection or bile leakage. Patients may require hospitalization for observation and management of any postoperative symptoms. The surgical site should be kept clean and dry, and any drains placed during the procedure will be monitored and managed as necessary. Recovery time may vary depending on the individual patient's condition and the extent of the surgery, but follow-up appointments will be necessary to assess healing and ensure the proper function of the biliary system.

Short Descr RECONSTRUCTION OF BILE DUCTS
Medium Descr RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST
Long Descr Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis
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
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).
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.
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.)
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
GW Service not related to the hospice patient's terminal condition
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