2025 CPT code 47541
Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Placement of access through the biliary tree and into the small bowel to assist with an endoscopic biliary procedure (e.g., rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (e.g., ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access.
Modifiers may be applicable. Refer to payer guidelines.
Medical necessity for 47541 must be supported by documentation of a failed or impossible endoscopic approach and the need for biliary access for diagnostic or therapeutic purposes.
When the patient is appropriately prepped and anesthetized, the provider makes an incision in the skin of the abdominal wall. Using image guidance, they insert a needle into the liver through a puncture and advance it through the common bile duct and into the small bowel. The provider inserts a guide wire through the needle, leaving it in place with its tip in the duodenum.
In simple words: The doctor creates a new access point through the skin and into the bile ducts and small intestine using imaging technology. This is done when a less invasive procedure couldn't reach the area. Sometimes, a dye is injected to help see the bile ducts better. The procedure includes the doctor's supervision and interpretation of the images.A small cut is made, and a needle is guided through the liver, bile duct, and into the intestine. A thin wire is then left in place to guide a later scope procedure.
The provider creates a new percutaneous access through the biliary tract and into the small intestine using ultrasound and/or fluoroscopy. This procedure is performed when access could not be established during an initial attempt at an endoscopic biliary procedure. It may also include diagnostic cholangiography. The procedure includes all associated radiological supervision and interpretation.The provider makes an incision in the skin of the abdominal wall and, using image guidance, inserts a needle into the liver and advances it through the common bile duct and into the small bowel. A guide wire is then inserted through the needle and left in place with its tip in the duodenum. During a repeat endoscopic biliary procedure, the endoscopist uses the guide wire to find the common bile duct.
Example 1: A patient has a blockage in the bile duct that cannot be accessed through a standard endoscopic procedure. The physician performs a percutaneous rendezvous procedure (47541) to establish access for a subsequent endoscopic intervention., A patient with a history of failed endoscopic retrograde cholangiopancreatography (ERCP) requires access to the biliary tree for stent placement. Code 47541 is used for the percutaneous access., A patient with a complex biliary stricture requires a combined percutaneous and endoscopic approach. The initial percutaneous access for guidewire placement is coded as 47541, facilitating the subsequent endoscopic procedure.
Documentation should include details of the failed endoscopic attempt, the percutaneous access procedure, including imaging guidance used, diagnostic cholangiography if performed, and radiological supervision and interpretation.
- Revenue Code: P1G - MAJOR PROCEDURE - OTHER
- Specialties:Interventional Radiology, Gastroenterology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center