# External Biliary Catheter Internalization



## drobinson1 (Jan 7, 2010)

I need a little help coding the following:

Patient is a 32 yr old female with an external biliary catheter. The patient presents for internalization.
The pre-existing  8 french Cope loop right sided biliary catheter was removed over wire. a 5 French catheter was inserted. Contrast was injected which revealed a  relative obstruction at the level of the common hepatic duct. I was able to negotiate a catheter and wire into the small bowel. 7 French sheath was inserted. Contrast was injected from the small bowel to the common hepatic duct. There is filling of nondialated right and left intrahepatic ducts. The proximal small bowel near the ampulla appears attenuated possibly by an extrinsic tumor. 
Susequently using standard catheter and guidwire exchange techniques a 10 french cope loop internal/external biliary catheter was inserted. Contrast was injected confirming positioning. initially there did not appear to be patency to internal drainage. Therefore the catheter will be left to external drainage.

I'm thinking 47500, 74320, 47525, 75984.


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## Twatson67 (Jan 8, 2010)

I agree and would code the same way.  Hope this helps


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## Anug123 (Jan 12, 2010)

According to Z-Health, Removal of External biliary catheter and placement of internal biliary drainage should be coded as 47511,75982.  If the contrast injection is performed via existing catheter we can code 47505,74305.

Hope this helps


Prabhavathi


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