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BETA v.3.0

2025 CPT code 47538

Placement of stent(s) into a bile duct, percutaneous, through an existing access. Includes diagnostic cholangiography, imaging guidance, balloon dilation, catheter exchange/removal, and radiological supervision and interpretation.

Refer to CPT and payer-specific guidelines for detailed instructions and appropriate modifier usage.

Modifier 59 may be applicable for distinct procedural services.

Medical necessity is based on the presence of a biliary obstruction or narrowing that compromises bile flow and requires intervention to restore drainage.Supporting documentation, such as imaging studies and clinical findings, should demonstrate the need for the stent placement.

The physician performs the procedure, including injecting contrast material for visualization, inserting the needle and guidewire, advancing the catheter/stent, dilating the duct with a balloon, and placing the stent.They also supervise and interpret the associated radiological imaging.

IMPORTANT:Do not report 47538 in conjunction with 47536, 47537 for the same percutaneous access.Use 47539 or 47540 for catheter placement through a new percutaneous access. Do not report 47542 (balloon dilation) with 47538. Do not report injection procedures for cholangiography (47531 or 47532) with 47538. Modifier 59 may be used for placement of side-by-side stents, multiple stents in separate ducts through single access, or placement of stents through multiple access sites.

In simple words: Placement of a stent (a small tube) in the bile duct through a small existing incision in the skin. This procedure helps keep the bile duct open. It includes X-ray imaging, ultrasound guidance, and other necessary procedures like expanding the duct with a balloon and changing or removing catheters.

Percutaneous placement of biliary stent(s) through an existing access, including diagnostic cholangiography, imaging guidance (e.g., fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s), and catheter removal(s) when performed, and all associated radiological supervision and interpretation.This code is used for each stent placed.

Example 1: A patient with a blockage in the bile duct due to a tumor has an existing percutaneous access site. A stent is placed through this access to maintain bile flow., A patient with a narrowed bile duct following surgery has an existing access. A stent is placed to keep the duct open and allow for proper drainage., A patient has a previous percutaneous biliary drain that is now being replaced with a stent to provide a more long-term solution for biliary drainage.

Documentation should include details of the existing percutaneous access, the reason for stent placement, the type of stent used, the location of placement within the biliary tree, any associated procedures performed (dilation, catheter exchange/removal), and the radiological findings.Medical necessity for the procedure must also be clearly documented.

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