47490 Modification Changes Your Cholecystostomy Coding

Read this article and correct a dangerous error in your manual.

After a 2011 code revision, 47490 joined the ranks of "complete" surgical codes -- meaning the encounter needs just one code to signify the procedure and associated radiology services. Read on for significant info on why CPT reviewed this code and how you're expected to use it to ensure accurate medical CPT coding.

See What Updated 47490 Includes to Earn $365

From the wide range of medical coding CPT codes, CPT 2011 reviewed 47490 so that it now signifies the "complete" service required for percutaneous creation of an opening in the gallbladder:
2010: 47490 (Percutaneous cholecystostomy)
2011: 47490 ( Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation.)

Percutaneous cholecystostomy is essentially a life-saving procedure which is used to buy time for those patients who are way too ill to undertake gallbladder removal.

Medicare's national rate for 47490 runs around $365, and CMS allocated the code a 10-day global period. That implies that associated E/M services on the day of the procedure (following decision for surgery) and for the 10 days subsequent to the procedure aren't payable distinctly. Actually, two post-procedure visits are factored into the fee.

Don't Unbundle Radiological Guidance

Code 47490 isn't the only one for this new "inclusive" emphasis. Medical CPT is continuing their preceding arrangement of bundling the given ancillary services that are normally part of procedures, including radiological guidance.

As a measure of the change to a "complete" code, CPT 2011 further adds a note along with 47490 informing you not to report the code along with 47505 (Injection procedure for cholangiography . . . ) or with radiology medical coding CPT codes 74305, 75989, 76942, 77002, 77012, and 77021.

Caution: You might find that your medical CPT coding manual challenges itself in the notes under 47490. As stated above, the manual states you must not report 47490 with 75989 (Radiological guidance [i.e., fluoroscopy, ultrasound, or computed tomography], for percutaneous drainage [e.g., abscess, specimen collection], with placement of catheter, radiological supervision and interpretation). But instantly under that, a lot of manuals have the following line, ‘For radiological supervision and interpretation, use 75989.'

Strike through: That last sentence was printed mistakenly in medical CPT coding manual 2011, as per AMA's published errata. In order to correct this erroneousness, you must delete the information that directs you to report code 75989 for radiological supervision.

Medical CPT Coding Tip: Carry on with Errata

The AMA provides provisional corrections to the published CPT manual.

Other existing corrections that could have an influence on your surgery practice consists of a note following 49419 (Insertion of tunneled intraperitoneal catheter, with subcutaneous port [i.e., totally implantable]). The modification directs coders to medical coding CPT codes 49020-49081 (Drainage . . . or Peritoneocentesis . . . ) meant for open or percutaneous peritoneal drainage or lavage.

Whether it's a powerful code reference tool, a real-time claims auditor to help you reduce denials or step-by-step guidance from CPC certified experts, we've got you covered. Some of our unique products provide you the update information on ICD-9 and HCPCS codes , the ammunition you need to get instant success.