# hepatico jejunal anastomosis balloon dilatation



## Shirleybala (Mar 30, 2009)

Hi:
How should I code for hepatico jejunal anastomosis balloon dilatation  
Can I code 47555.

       Procedure: Risks, benefits, alternatives and possible
       complications of the procedure were discussed with the patient
       understood and consent willingly.  With the patient in the supine
       position the left abdomen and indwelling catheter was prepped and
       draped in the usual sterile fashion.  The indwelling stent was
       then removed over a wire and exchanged for an 8-French sheath.
       After placement of a stiff guidewire, and the stricture of the
       hepatico jejunal anastomosis was dilated using a 14-mm mm x 4 cm
       Atlas angioplasty balloon. Repeat cholangiogram was performed.  A
       14 French internal external biliary drain which was then placed
       with its tip in the bowel.  The external end of the catheter was
       capped to drainage bag The patient tolerated the procedure without
       incident.

       Findings: Initial cholangiogram demonstrates a nondilated biliary
       system. Flow through the biliary system is noted.  However,
       recurrent stricture of the hepaticojejunal anastomosis is noted.
       This stricture was dilated using a 14-mm diameter angioplasty
       balloon.  The drainage of the biliary system post stenting was
       good.

       Conclusion: Cholangiogram demonstrates some flow through but with
       recurrent stricture of the hepaticojejunal anastomosis. Balloon
       dilatation of stricture of hepaticojejunal anastomosis was
       performed using a 14 -mm diameter angioplasty balloon with good
       cosmetic result.  14-French internal-external biliary drainage
       catheter left in place across the left biliary tree extending into
       the bowel. The patient is to return for follow-up examination in
       one month.


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## MLS2 (Apr 1, 2009)

I am thinking 47555 would be correct

Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) without stent


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