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The CPT® Code 48551 refers to the backbench standard preparation of a cadaver donor pancreas allograft prior to transplantation. This procedure is critical in ensuring that the pancreas is adequately prepared for successful transplantation into a recipient. The process begins with the careful removal of the pancreas from its sterile container, where it is then placed on ice and immersed in a cold preservation solution to maintain its viability. A thorough inspection of the pancreas is conducted to confirm that it is intact and suitable for transplant. This preparation involves several intricate steps, including the removal of the attached spleen through the careful ligation and division of splenic vessels, as well as the opening of the duodenum to locate the sphincter of Oddi. A catheter is utilized to navigate through the common bile duct, confirming the correct positioning of the sphincter. The duodenum is then shortened at both ends, and the mesenteric vessels are ligated and divided to facilitate the separation of the duodenum from the distal pancreas. The remaining duodenum is secured by stapling and oversewing its ends. Additionally, the common bile duct is ligated, and the middle colic vessels are ligated at the base of the transverse mesocolon, along with the superior mesenteric vessels at the root of the small bowel mesentery. A Y-graft is constructed to connect the external and internal iliac arteries to the superior mesenteric artery, ensuring proper vascular supply to the pancreas. Throughout this meticulous preparation, the pancreas remains on ice and continues to be bathed in cold preservation solution until the recipient is ready for transplantation.
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The backbench standard preparation of a cadaver donor pancreas allograft is indicated for the following conditions:
The procedure for backbench preparation of the cadaver donor pancreas allograft involves several critical steps:
After the backbench preparation of the pancreas allograft, the organ is kept on ice and in cold preservation solution until the recipient is ready for transplantation. It is crucial to monitor the condition of the pancreas during this time to ensure that it remains viable for successful implantation. The surgical team must be prepared to proceed with the transplantation as soon as the recipient is ready, minimizing the time the pancreas is outside of a controlled environment to enhance the chances of a successful transplant outcome.
| Short Descr | PREP DONOR PANCREAS | Medium Descr | BKBENCH PREPJ CADAVER DONOR PANCREAS ALLOGRAFT | Long Descr | Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and Y-graft arterial anastomoses from iliac artery to superior mesenteric artery and to splenic artery | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | 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 | 176 - Other organ transplantation |
| 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). | 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). | 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. | 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). | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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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| 2005-01-01 | Added | First appearance in code book in 2005. |
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