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2025 CPT code 47534

Placement of a biliary drainage catheter through the skin, with internal and external drainage, using imaging guidance and including diagnostic cholangiography.

Code 47534 is reported once for each internal-external biliary drainage catheter placed. Modifier 59 may be appended for each additional catheter placed via a separate access site.

Medical necessity for 47534 is established by the presence of a condition requiring biliary drainage, such as obstructive jaundice, biliary stricture, or bile leak. Documentation should support the clinical rationale for the procedure.

After preparing and anesthetizing the patient, the physician uses imaging guidance to insert a needle into the liver and advance it to the bile duct. A guide wire is then inserted through the needle, followed by a drainage catheter, which is advanced into the bile ducts and through any obstruction. The guide wire is removed, and the catheter is secured in place, with one end draining bile into the small intestine and the other end connected to an external drainage system. A bandage is applied at the puncture site. Cholangiography, involving injecting a contrast dye to visualize the bile ducts, may also be performed.

In simple words: A catheter is inserted through the skin into the bile ducts to drain bile both internally and externally. This is done using imaging technology like ultrasound and may include injecting a dye to visualize the bile ducts. The drainage helps to remove bile that is important for digestion but can cause problems if it builds up.

Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external.

Example 1: A patient presents with obstructive jaundice due to a blockage in the common bile duct. Percutaneous placement of an internal-external biliary drainage catheter (47534) is performed to relieve the obstruction and allow for both internal and external drainage of bile., A patient with a malignant biliary stricture requires palliative drainage. Code 47534 is used for the percutaneous placement of an internal-external biliary drainage catheter to alleviate symptoms and improve quality of life., Following a cholecystectomy, a patient develops a bile leak. Percutaneous placement of an internal-external biliary drainage catheter (47534) is performed to divert bile externally while the leak heals internally.

Documentation should include details of the procedure, including the type of imaging guidance used, confirmation of internal and external drainage, any associated cholangiography performed, and the reason for the catheter placement (e.g., obstruction, leak).

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