Mountain State Medical Policy Bulletin
Section: Surgery
Number: S-25
Topic: Operative Cholangiography Prior to Exploration of the Common Bile Duct
Effective Date: July 21, 2008
Issued Date: July 21, 2008
Date Last Reviewed: 07/2008

General Policy Guidelines

Indications and Limitations of Coverage

Frequently, during cholecystectomy, an operative cholangiography is performed to help decide whether or not to explore the common bile duct for stones. When one physician reports cholecystectomy and operative cholangiography with subsequent common bile duct exploration, the services are combined under procedure code 47564 or 47610, as appropriate.  Modifier 59 may be reported with a non-E/M service, to identify it as distinct or independent from other non-E/M services performed on the same day.  When modifier 59 is reported, the patient’s records must support its use in accordance with CPT guidelines.

If, however, a second physician, e.g., a radiologist, reports the operative cholangiography, the service is eligible under codes 74300-74301.

Description

Operative cholangiography involves the injection of dye into the cystic or common bile duct during surgery. It is used to identify various abnormalities of the duct system.

Procedure Codes

47564476107430074301  

Traditional Guidelines

Refer to General Policy Guidelines

FEP Guidelines

Refer to General Policy Guidelines

PPO Guidelines

Refer to General Policy Guidelines

Managed Care POS Guidelines

Refer to General Policy Guidelines

Publications

References

View Previous Versions

[Version 003 of S-25]
[Version 002 of S-25]
[Version 001 of S-25]

Table Attachment

Text Attachment

Procedure Code Attachments

Diagnosis Codes

Glossary




This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical records.

Medical policies are designed to supplement the terms of a member's contract. The member's contract defines the benefits available; therefore, medical policies should not be construed as overriding specific contract language. In the event of conflict, the contract shall govern.

Medical policies do not constitute medical advice, nor the practice of medicine. Rather, such policies are intended only to establish general guidelines for coverage and reimbursement under Mountain State Blue Cross Blue Shield plans. Application of a medical policy to determine coverage in an individual instance is not intended and shall not be construed to supercede the professional judgment of a treating provider. In all situations, the treating provider must use his/her professional judgment to provide care he/she believes to be in the best interest of the patient, and the provider and patient remain responsible for all treatment decisions.

Mountain State Blue Cross Blue Shield (MSBCBS) retains the right to review and update its medical policy guidelines at its sole discretion. These guidelines are the proprietary information of MSBCBS. Any sale, copying or dissemination of the medical policies is prohibited; however, limited copying of medical policies is permitted for individual use.