2025 CPT code 47536
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Biliary System Surgery Feed
Percutaneous exchange of a biliary drainage catheter (external, internal-external, or conversion of internal-external to external only), encompassing diagnostic cholangiography if performed, imaging guidance (fluoroscopy), and associated radiological supervision and interpretation.
Modifiers 26, TC, 59, 76, 77, 78, 79, 80, 81 may be applicable depending on the specific circumstances of the service.
Medical necessity for 47536 is established by a documented need for biliary drainage due to an obstruction or other pathology affecting the biliary system.The condition must impede the normal flow of bile, necessitating the use of a catheter to alleviate symptoms and prevent complications.
The physician is responsible for the insertion, exchange, or removal of the biliary drainage catheter, as well as interpretation of any associated imaging studies.This includes pre-procedural planning, selecting the appropriate catheter type, and post-procedural care.
In simple words: The doctor replaces a tube used to drain bile from the body. This might involve changing an existing tube or converting a tube that drains bile both inside and outside the body to one that only drains outside.The procedure uses imaging technology like X-rays to guide the process and includes all related image reading and interpretation.
This CPT code, 47536, describes the percutaneous exchange of a biliary drainage catheter.This procedure involves replacing an existing catheter used to drain bile from the biliary system. The types of catheters this code applies to are external, internal-external, or conversion of an internal-external catheter to an external-only catheter. The procedure includes diagnostic cholangiography (if performed), imaging guidance (e.g., fluoroscopy), and all associated radiological supervision and interpretation.The exchange of one catheter is included; additional exchanges during the same session require modifier 59 for each additional exchange.
Example 1: A patient with a malignant biliary obstruction requires an exchange of their existing external biliary drainage catheter due to catheter blockage.47536 is used to code the exchange., A patient with choledocholithiasis (gallstones in the common bile duct) undergoes a percutaneous cholecystotomy, followed by placement of an internal-external biliary drainage catheter. During a follow-up visit, the internal portion of the catheter is removed, converting it to an external-only drain (47536)., A patient with pancreatitis and a blocked bile duct requires multiple biliary drainage catheter exchanges during a single procedure due to recurrent clogging. Each additional exchange after the first would be coded 47536 with modifier 59.
Detailed operative notes describing the type of catheter exchanged (external, internal-external, or conversion), the method of access, imaging guidance used (fluoroscopy or ultrasound), and the results of any diagnostic cholangiography. Preoperative and postoperative imaging studies.Documentation supporting medical necessity, including the diagnosis requiring biliary drainage.Patient's history and physical examination.
** The description of this code emphasizes that the exchange of only *one* catheter is included in the code.Any additional exchanges in the same session require the use of modifier 59.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: This information requires access to a specific fee schedule and may vary based on location, payer, and other factors.Refer to your specific payer's fee schedule.
- Global Days: The global period information is not explicitly provided in the source.Additional research into specific payer guidelines is necessary.
- Payment Status: Active
- Modifier TC rule: Modifier TC (Technical Component) may apply if the service is performed by a facility or hospital.
- Fee Schedule: This data is dependent on the specific payer and is not provided in the source.
- Specialties:Gastroenterology, Radiology, Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center