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The procedure described by CPT® Code 48020 involves the surgical removal of a pancreatic calculus, commonly referred to as a stone. This condition typically arises when digestive enzymes and other substances in the pancreas crystallize, forming a solid mass that can obstruct pancreatic ducts. The removal of such a calculus is critical to alleviate symptoms and prevent complications associated with pancreatic duct obstruction, such as pancreatitis or infection. During the procedure, a surgical incision is made, either subcostally (below the rib cage) or through a midline approach in the abdomen, allowing access to the pancreas. Once the pancreas is visualized, the surgeon inspects it to locate the stone. An incision is then made directly over the stone within the pancreatic duct, facilitating its extraction. After the calculus is removed, the surgeon meticulously closes the incision in both the pancreatic duct and the pancreas itself. To ensure proper healing and drainage, the surgical site is irrigated, and drains are placed before the final closure of the wound. This procedure is essential for restoring normal pancreatic function and preventing further complications related to pancreatic stones.
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The procedure for the removal of a pancreatic calculus is indicated in specific clinical scenarios where the presence of a stone in the pancreas leads to significant health issues. The following conditions may warrant this surgical intervention:
The procedure for the removal of a pancreatic calculus involves several critical steps to ensure successful extraction and patient safety. The following outlines the procedural steps:
Post-procedure care following the removal of a pancreatic calculus is essential for ensuring proper recovery and monitoring for potential complications. Patients are typically observed for any signs of infection or complications related to the surgery. The presence of drains may require careful management to prevent blockage and ensure adequate drainage. Patients may experience some discomfort and will be monitored for pain management. Follow-up appointments are crucial to assess healing and to ensure that the pancreatic duct is functioning properly after the procedure. Dietary modifications may also be recommended to support recovery and prevent further complications.
| Short Descr | REMOVAL OF PANCREATIC STONE | Medium Descr | REMOVAL PANCREATIC CALCULUS | Long Descr | Removal of pancreatic calculus | 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). | 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). | 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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