# Coding ERCP



## tholcomb (Oct 31, 2012)

Good morning all,

Patient had ERCP done cpt codes 43264,43262,43271, & 74328 procedure below.


Findings: The ampulla appeared normal, though no bile was seen coming from it. The bile duct was cannulated with 
a sphincterotome (Dash 21) and a wire was advanced into the intra-hepatic ducts.  Initial contrast injection did not show any filling defects, though the CBD was mildly dilated without intrahepatic dilatation.  A 5 mm sphincterotomy was performed and bile began draining freely. An 8.5/11/15 mm balloon catheter was advanced into the duct and a ballon occlusion cholangiogram was performed.  Multiple balloon sweeps yielded two small, dark stone fragments, but the sweeps were otherwise normal.  Contrast drained easily and spontaneously.  The common bile duct appeared to taper smoothly and normally distally. The pancreatic duct was intentionally not entered to reduce the risk of pancreatitis.

Thank you,
TH


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