CPT® Code 75980 | Case2Code

Code deleted, to report see 47533, 47534, 47535, 47536, 47537

Official Description

Percutaneous transhepatic biliary drainage with contrast monitoring, radiological supervision and interpretation

Common Language Description

The CPT® Code 75980 refers to the procedure of percutaneous transhepatic biliary drainage, which is performed under radiological supervision and interpretation. This procedure is primarily indicated for patients experiencing obstructions in the bile duct, which can arise from various conditions such as gallstones, tumors, infections, cirrhosis, or trauma. The process begins with the insertion of a small needle through the skin at the site where a catheter or stent will be placed, allowing access to the bile duct. Once the needle is in position, contrast media is injected to verify the correct location within the bile duct. Following this, a guidewire is introduced through the needle, which is then removed, allowing for the insertion of a catheter over the guidewire. This catheter is utilized to navigate the bile duct, and any strictures encountered during the procedure are dilated to facilitate drainage. In cases where an internal and external biliary drain is necessary, the drain is positioned such that its drainage holes are situated above the stricture. If the drain cannot be maneuvered past the obstruction, an external drain is placed proximal to the blockage. Should a stent be required for drainage, it is advanced to the stricture site over a guidewire and expanded within the bile duct to alleviate the narrowing, thereby enabling the blocked bile duct to drain into the small intestine. The stent is designed with a second portion that exits the skin, allowing for external drainage. After the catheter placement, additional contrast is injected to confirm the patency of the bile duct. The code 75980 encompasses the radiologist's role in supervising the procedure, interpreting the findings, generating a written report, and consulting with referring physicians regarding the diagnosis and potential need for further interventions.

1. Indications

The procedure associated with CPT® Code 75980 is indicated for the following conditions:

Obstruction due to stones - This may include gallstones or other calculi that block the bile duct, preventing bile from flowing properly.
Obstruction due to tumors - Tumors, whether benign or malignant, can compress or invade the bile duct, leading to obstruction.
Infection - Infections in the biliary system can cause inflammation and subsequent blockage of the bile duct.
Cirrhosis - Liver cirrhosis can lead to changes in bile duct structure and function, resulting in obstructions.
Trauma - Physical injury to the abdomen can damage the bile duct, leading to obstruction and necessitating drainage.

2. Procedure

The procedure for CPT® Code 75980 involves several critical steps to ensure effective biliary drainage:

Step 1: Needle Insertion - A small needle is carefully inserted through the skin at the predetermined site for catheter or stent placement, targeting the bile duct. This initial step is crucial for accessing the biliary system.
Step 2: Contrast Injection - Once the needle is in place, contrast media is injected through the needle to confirm its correct positioning within the bile duct. This imaging step is essential for visualizing the anatomy and any obstructions present.
Step 3: Guidewire Placement - A guidewire is then passed through the needle into the bile duct. After successful placement of the guidewire, the needle is removed, leaving the guidewire in position to facilitate further steps.
Step 4: Catheter Insertion - A catheter is inserted over the guidewire into the bile duct. This catheter serves as the primary conduit for drainage and is essential for managing the obstruction.
Step 5: Dilation of Strictures - If any strictures are encountered during the procedure, they are dilated to allow for better drainage and to facilitate the placement of the biliary drain.
Step 6: Drain Placement - An internal and external biliary drain is placed, ensuring that the drainage holes are positioned above the stricture. If the drain cannot be maneuvered past the obstruction, an external drain is placed proximal to the blockage.
Step 7: Stent Insertion (if necessary) - If a stent is required, it is advanced to the stricture site over the guidewire and expanded within the bile duct to alleviate the narrowing, allowing bile to flow into the small intestine.
Step 8: Final Contrast Injection - After the catheter or stent is in place, additional contrast is injected to ensure that the bile duct remains patent and that the drainage system is functioning correctly.

3. Post-Procedure

Post-procedure care for patients undergoing CPT® Code 75980 typically involves monitoring for any complications related to the drainage procedure. Patients may be observed for signs of infection, bleeding, or any adverse reactions to the contrast media used during the procedure. Follow-up imaging may be required to confirm the effectiveness of the drainage and to ensure that the bile duct remains patent. Additionally, patients may need to be educated on signs and symptoms that warrant immediate medical attention, such as fever, increased abdominal pain, or changes in drainage output. Coordination with the referring physician may also be necessary to discuss the findings and any further diagnostic or therapeutic interventions that may be indicated based on the results of the procedure.

Short Descr	CONTRAST XRAY EXAM BILE DUCT
Medium Descr	PRQ TRANSHEPATC BILIARY DRG W/CONTRAST MNTR RS&I
Long Descr	Percutaneous transhepatic biliary drainage with contrast monitoring, radiological supervision and interpretation
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No 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)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Items and Services Packaged into APC Rates
Type of Service (TOS)	6 - Therapeutic Radiology
Berenson-Eggers TOS (BETOS)	I1F - Standard imaging - other
MUE	Not applicable/unspecified.
CCS Clinical Classification	226 - Other diagnostic radiology and related techniques