2025 CPT code 47553
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endoscopy Procedures on the Biliary Tract Surgery Feed
Percutaneous biliary endoscopy through a T-tube or other tract, involving a biopsy (single or multiple).
Modifiers may apply depending on circumstances such as multiple procedures (modifier 51), reduced services (modifier 52), or staged procedures (modifier 58).
Medical necessity is established when clinical findings suggest a biliary abnormality necessitating visualization and tissue sampling for diagnosis and/or treatment. Examples include unexplained jaundice, persistent biliary pain, elevated liver enzymes, or suspicion of malignancy or infection. Imaging studies often support the need for the procedure.
The clinical responsibility lies with the physician performing the endoscopy. This includes patient preparation, anesthesia administration (if applicable), choledochoscope insertion and manipulation, tissue sampling (biopsy), specimen collection and handling, and post-procedure care.
In simple words: A thin, flexible tube with a camera and light is inserted through an existing tube in the belly to examine the bile ducts.Pictures are taken, and small tissue samples may be collected for testing to check for problems.
This procedure involves the percutaneous insertion of a biliary endoscope (choledochoscope) through a pre-existing T-tube or other tract in the abdominal wall to visualize the biliary ducts. The procedure includes examination of the biliary ducts, potentially utilizing fluoroscopic guidance or cholangiography (with contrast dye injection).Biopsies (single or multiple) of suspicious tissue are obtained using forceps passed through the endoscope's working channel. The collected specimens are then sent to a pathology laboratory for analysis.All instruments are subsequently withdrawn, and the choledochoscope is removed.
Example 1: A patient presents with persistent jaundice and elevated liver enzymes following cholecystectomy.A percutaneous transhepatic cholangiogram reveals a suspected stricture in the common bile duct.A biliary endoscopy with biopsy is performed to confirm the diagnosis and assess the tissue for malignancy., A patient with a T-tube in place after a Whipple procedure experiences recurrent biliary pain. Biliary endoscopy with biopsy is performed to rule out malignancy or infection., Following an ERCP, a patient develops cholangitis.Percutaneous biliary endoscopy is conducted via the existing stent to obtain a tissue sample for microbiological analysis and to perform a therapeutic lavage to treat the infection.
Detailed operative report describing the procedure, including the approach (T-tube or other tract), the findings during endoscopy, the number and location of biopsies taken, the results of any imaging studies (cholangiography, fluoroscopy), and the final disposition of the tissue samples.Preoperative and postoperative imaging studies should be included, along with the patient’s history and physical examination findings.
** This code is usually used when the procedure is done percutaneously.It is important to always clarify whether or not cholangiography or fluoroscopy is included as this can affect reimbursement.Accurate documentation is crucial for proper coding and billing.
- Global Days : Percutaneous biliary drainage procedures, including this one, typically have a global surgical period of 0-90 days.Modifier 58 should be appended if a staged procedure is performed by the same physician within this period.
- Payment Status: Active
- Modifier TC rule: The TC modifier (Technical Component) is not applicable to this code as it represents the entire procedure.
- Specialties:Gastroenterology, Hepatology, Interventional Radiology, Surgery
- Place of Service:Hospital (Inpatient or Outpatient), Ambulatory Surgical Center