2025 CPT code 47490
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Percutaneous cholecystostomy; complete procedure including imaging guidance, catheter placement, cholecystogram (if performed), and radiological supervision and interpretation.
Modifiers may be used as appropriate to indicate multiple procedures, unusual circumstances, or other necessary adjustments. Consult the CPT manual for guidance on appropriate modifier selection.
Medical necessity for percutaneous cholecystostomy is established when a patient presents with acute cholecystitis and other treatment options are not feasible or have failed.The procedure is indicated for decompression of the inflamed gallbladder, preventing complications such as rupture or abscess formation.
The procedure is performed by a physician specializing in radiology or surgery, requiring expertise in image-guided interventions and biliary drainage techniques. The physician is responsible for pre-procedural assessment,needle placement, guidewire insertion, catheter placement, cholecystogram (if performed), fluid drainage, and post-procedural care.
In simple words: This procedure involves making a small opening in the gallbladder through the skin to insert a tube for drainage.Imaging is used to guide the process, and pictures of the gallbladder might be taken as part of the procedure.
Percutaneous cholecystostomy is a minimally invasive procedure involving the creation of an opening in the gallbladder through the skin using imaging guidance (ultrasound and/or fluoroscopy).A catheter is then inserted into the gallbladder for drainage.A cholecystogram (radiological imaging of the gallbladder) may be performed as part of the procedure.The procedure includes all associated radiological supervision and interpretation.
Example 1: A patient presents with acute cholecystitis (gallbladder inflammation) and a large amount of fluid buildup.Percutaneous cholecystostomy is performed to decompress the gallbladder, relieving symptoms and preventing further complications. A cholecystogram is performed to assess the extent of the inflammation and identify any stones., A patient with a known history of gallstones develops severe abdominal pain suggestive of acute cholecystitis.Percutaneous cholecystostomy is performed as an emergency procedure to relieve pressure and prevent gallbladder rupture., A patient is unable to undergo cholecystectomy (surgical removal of the gallbladder) due to other medical conditions. Percutaneous cholecystostomy is performed to provide long-term gallbladder drainage, allowing management of the underlying biliary disease.
* Detailed history and physical examination documenting the clinical indication for the procedure (e.g., acute cholecystitis, inability to tolerate surgery).* Imaging studies (ultrasound, CT scan) to confirm the diagnosis and guide the procedure.* Operative report documenting the technique used, catheter placement details, and any complications.* Pathology report (if a bile sample was obtained).* Post-procedure imaging to confirm proper catheter placement and drainage.
** This code encompasses the complete procedure, including all imaging guidance, catheter placement, and radiological interpretation. Any additional procedures performed during the same session should be reported separately with appropriate modifiers as needed.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: No TC modifier is applicable.
- Specialties:Radiology, Surgery, Gastroenterology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center