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The procedure described by CPT® Code 48556 involves the surgical removal of a transplanted pancreatic allograft. This operation is typically necessitated by complications that may arise post-transplant, such as graft rejection, which occurs when the recipient's immune system attacks the transplanted organ, or due to infection, where the allograft becomes compromised by bacterial or viral pathogens. Additionally, malignancy, or the presence of cancerous cells within the transplanted pancreas, can also warrant its removal. The surgical process begins with an incision in the abdomen to access the transplanted pancreas. Once the allograft is visualized, the surgeon evaluates its condition to confirm that it is not functioning adequately. If the decision is made to proceed with the removal, the surgeon will clamp and transect the donor portal vein and donor iliac artery to prevent blood loss. The vascular anastomosis sites, where the allograft was connected to the recipient's blood vessels, are then repaired to restore normal blood flow. The pancreas is detached at the anastomosis sites, which may be located in the jejunum (part of the small intestine) or the urinary bladder, depending on the original surgical technique used for transplantation. After the pancreas is removed, the sites of the jejunum or urinary bladder are repaired, drains may be placed to prevent fluid accumulation, and the abdominal cavity is subsequently closed. This procedure is critical in managing complications associated with pancreatic transplants and ensuring the health and safety of the recipient.
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The removal of a transplanted pancreatic allograft, as indicated by CPT® Code 48556, is performed under specific circumstances that necessitate intervention. The primary indications for this procedure include:
The procedure for the removal of a transplanted pancreatic allograft involves several critical steps, each essential for ensuring the safe and effective extraction of the organ. The steps are as follows:
After the removal of the transplanted pancreatic allograft, the patient will require careful monitoring and post-operative care. This includes managing any potential complications that may arise from the surgery, such as infection or bleeding. The placement of drains will help in monitoring fluid output and preventing fluid accumulation in the abdominal cavity. Patients may also need to follow specific dietary guidelines and may require adjustments in their medication regimen, particularly if they were on immunosuppressive therapy prior to the procedure. Recovery time can vary based on the individual’s overall health and the complexity of the surgery, and follow-up appointments will be necessary to assess healing and any further treatment needs.
| Short Descr | REMOVAL ALLOGRAFT PANCREAS | Medium Descr | RMVL TRANSPLANTED PANCREATIC ALLOGRAFT | Long Descr | Removal of transplanted pancreatic allograft | 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) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 2 - Team surgeons permitted; pay by report. | 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. | 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 |
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| 2011-01-01 | Changed | Short description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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