2025 CPT code 47539
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Percutaneous placement of stent(s) in a bile duct; new access, without separate drainage catheter.
Modifier 59 (Distinct procedural service) may be applied in specific circumstances as detailed in the CPT guidelines.
Medical necessity is established by the presence of a biliary obstruction that is causing clinical symptoms (e.g., jaundice, cholangitis) and requires intervention to restore biliary drainage. The procedure must be deemed medically appropriate and necessary by the treating physician.
The physician injects contrast material, uses imaging guidance to access the bile duct percutaneously, inserts a guidewire and catheter/stent, performs balloon dilation (if needed), and places the stent.Radiological supervision and interpretation are included.
In simple words: A small incision is made in the skin, and a tube-like device (stent) is placed inside a bile duct to keep it open.This may involve imaging techniques and widening the duct. A separate drainage tube is not used.
Percutaneous placement of stent(s) into a bile duct, encompassing diagnostic cholangiography, imaging guidance (fluoroscopy and/or ultrasound), balloon dilation (if performed), catheter exchanges and removals (if performed), and all associated radiological supervision and interpretation; new access, without placement of a separate biliary drainage catheter.
Example 1: A patient presents with a bile duct stricture causing jaundice.The physician performs a percutaneous transhepatic cholangiogram, places a self-expanding metallic stent across the stricture to relieve the obstruction, and confirms patency with post-procedure imaging., A patient with pancreatic cancer has a malignant biliary obstruction. The physician uses a percutaneous approach to place a plastic stent for biliary drainage, and post-procedure imaging confirms stent position and drainage., A patient with choledocholithiasis (gallstones in the common bile duct) undergoes percutaneous biliary access.After removal of the gallstones, a stent is placed for temporary biliary drainage and then removed at a later date.
Pre-procedure imaging (e.g., CT scan, MRI, ultrasound), informed consent, operative report detailing the procedure, including type and number of stents placed, imaging findings, and post-procedure imaging to confirm stent placement and patency.
** This code describes a percutaneous stent placement without a separate drainage catheter.If a drainage catheter is placed, use code 47540.The use of modifier 59 should be carefully considered and justified in accordance with CPT guidelines.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Interventional radiology, gastroenterology, surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center