# Transcatheter biliary brush biopsy



## prabha (Feb 5, 2009)

Hi all,
These are the codes for the below report.Pls confirm brush biopsy code         (47553)

47525
47553
47505
75984-26
74320-26
      Procedure:       
       Transcatheter cholangiogram
       Exchange of  transhepatic biliary drain.
       Transcatheter biliary brush biopsy              

       Following informed consent, the right flank and right lower chest
       were prepped and draped in sterile fashion.  The previously placed
       catheter was also prepped and draped in a sterile fashion.       

       Via the biliary drainage catheter, Contrast was hand injected and
       transcatheter cholangiogram was performed.

       A guide wire was passed into the biliary tree and into the bowel.
       The previously placed biliary drain was removed.  A 7-French
       vascular sheath was placed until the tip was at the
       biliary-enteric  anastomotic site.  Multiple brush biopsies (total
       of 4) of the site were obtained and sent for cytologic evaluation.

       A new 10.2 French internal/external biliary drainage catheter was
       positioned.  The catheter was secured to the skin and connected to
       gravity drainage.            

       Findings:             
       Transcatheter cholangiography demonstrates interval improvement in
       previously dilated biliary tree.  The patient is status post right
       hepato-jejunostomy.  There is a high grade obstruction of the
       confluence of the ducts of the right lobe extending to the
       hepato-jejunostomy.  This diseased segment was brushed for
       cytologic evaluation and a new 10.2 Fr internal external biliary
       drain was placed.  The locking loop of the catheter is in the
       small bowel.      

       Impression:       
       Transhepatic cholangiogram showing internal decrease in biliary
       duct dilatation and persistent high grade obstruction of the right
       biliary duct confluence extending  to the hepata-jejunostomy.
       This was brushed with four GI biopsy brush and sent for cytology.

       Fluoroscopic guided exchange of 8.5 French biliary drainage
       catheter for a new 10.2 Fr internal external biliary drainage
       catheter.


----------



## MLS2 (Feb 12, 2009)

I was looking at:
74305
47505-51
75984
47525-51
47552 (Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with or without collection of specimen(s) by brushing and/or washing (separate procedure)


----------

