2025 CPT code 47542
Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Percutaneous balloon dilation of biliary duct(s) or ampulla (sphincteroplasty), with imaging guidance and radiological supervision.
Modifiers may be applicable. Modifier 59 may be necessary to distinguish separate and distinct dilations performed through different accesses during the same session.
Medical necessity must be established for this procedure. The documentation should clearly demonstrate the clinical indication for the dilation, such as a symptomatic biliary stricture or difficulty with bile drainage.
The physician performing the procedure is responsible for prepping and anesthetizing the patient, accessing the biliary system percutaneously using imaging guidance, performing the balloon dilation, and managing any complications.
In simple words: The doctor uses a small balloon to widen a narrowed bile duct or the opening where the bile duct and pancreatic duct enter the small intestine. This procedure is done through the skin, using X-ray imaging to guide the process.
This code describes a percutaneous balloon dilation of the biliary duct(s) or the ampulla of Vater (sphincteroplasty), performed using imaging guidance (e.g., fluoroscopy) and including all associated radiological supervision and interpretation.It is reported for each dilated duct and is used in conjunction with a primary procedure code.It is not reported with stent placement codes (47538-47540) as dilation is included in those codes, nor is it reported with endoscopic dilation codes or if a balloon is used for removal of calculi or debris rather than dilation.
Example 1: A patient with a biliary stricture undergoes percutaneous transhepatic cholangiography (PTC) (47531) which confirms the stricture. Balloon dilation of the stricture is performed (47542)., During a percutaneous biliary drainage procedure (47533), a stenosis is encountered in a secondary bile duct. The primary duct is successfully stented, and the secondary duct is dilated using balloon dilation (47542)., A patient with a previous percutaneous biliary drain returns for a drain exchange (47536) and during the procedure, a stricture is noted and dilated (47542).
Documentation should include details of the imaging guidance used, the location and nature of the stricture or ampullary stenosis, the size of the balloon used for dilation, any complications encountered, and the final outcome of the procedure.
- Specialties:Interventional Radiology, Gastroenterology, General Surgery
- Place of Service:Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital