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Official Description

Placement of choledochal stent

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 47801 involves the placement of a choledochal stent, which is a medical intervention aimed at alleviating chronic obstruction of the common bile duct. This obstruction is often associated with malignancies, which can lead to significant complications if not addressed. During the procedure, a midline abdominal incision is made to provide access to the liver, gallbladder, and common bile duct. Once these structures are exposed, the common bile duct is incised to allow for the insertion of a biliary plastic or metal tube, known as a stent, into the narrowed segment of the duct. This stent serves to maintain patency and facilitate the flow of bile, thereby relieving the obstruction. After the stent is placed, the incision in the common bile duct is closed, and the effectiveness of the procedure is verified through a cholangiogram, which is a separate reportable imaging study that assesses the bile duct's patency. Following the completion of the stent placement, the surgical wound is irrigated, and drains may be placed as necessary to manage any potential fluid accumulation. Finally, the abdominal incision is closed in layers to promote proper healing and minimize the risk of complications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The placement of a choledochal stent is indicated for patients experiencing chronic obstruction of the common bile duct. This condition is particularly prevalent in cases where the obstruction is caused by malignancies, which can lead to bile duct blockage and subsequent complications such as jaundice, cholangitis, or pancreatitis. The procedure aims to restore bile flow and alleviate symptoms associated with the obstruction.

  • Chronic Obstruction of the Common Bile Duct This condition often arises due to malignancies that can compress or invade the bile duct, leading to significant clinical symptoms.

2. Procedure

The procedure for the placement of a choledochal stent involves several critical steps to ensure successful intervention. Initially, an abdominal incision is made in the midline, providing access to the necessary anatomical structures. Once the incision is made, the liver, gallbladder, and common bile duct are carefully exposed to facilitate the next steps of the procedure.

  • Step 1: Incision and Exposure The surgeon makes a midline abdominal incision to access the liver, gallbladder, and common bile duct. This step is crucial for visualizing the area where the obstruction occurs.
  • Step 2: Incision of the Common Bile Duct After exposure, the common bile duct is incised to allow for the placement of the stent. This incision is necessary to access the narrowed segment of the duct that requires intervention.
  • Step 3: Placement of the Stent A biliary plastic or metal tube, referred to as a stent, is inserted into the narrowed segment of the common bile duct. This stent is designed to maintain the duct's patency and facilitate bile flow.
  • Step 4: Closure of the Common Bile Duct Following the stent placement, the incision in the common bile duct is closed. This step is essential to prevent bile leakage and ensure the integrity of the duct.
  • Step 5: Verification of Patency The effectiveness of the stent placement is verified through a cholangiogram, which is a separate reportable imaging study that assesses the patency of the bile duct.
  • Step 6: Wound Management After verifying the patency, the surgical wound is irrigated to reduce the risk of infection. Drains may be placed as needed to manage any fluid accumulation.
  • Step 7: Closure of the Abdominal Incision Finally, the abdominal incision is closed in layers to promote proper healing and minimize complications.

3. Post-Procedure

Post-procedure care following the placement of a choledochal stent includes monitoring for any signs of complications, such as infection or bile leakage. Patients may require follow-up imaging studies to ensure the stent remains patent and that bile flow is adequately restored. Additionally, healthcare providers may need to manage any drains that were placed during the procedure to prevent fluid accumulation. Recovery time can vary based on the individual patient's condition and the complexity of the procedure, but careful monitoring and follow-up are essential to ensure optimal outcomes.

Short Descr PLACEMENT BILE DUCT SUPPORT
Medium Descr PLACEMENT CHOLEDOCHAL STENT
Long Descr Placement of choledochal stent
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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, 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
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
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Notes
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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