General Surgery Coding Alert

Question: My surgeon performed a lap chole with both cholangiography and exploration of the common duct. I reported 47563 and 47564, but the payer reimbursed only 47564. Is this correct, or can we gain additional payment for the cholangiography in a different way (perhaps using a modifier)?


Pennsylvania Subscriber


Answer: Your payer was correct. You cannot gain additional compensation for the cholangiography in this case, with or without a modifier.

If the surgeon performs both cholangiography and exploration of the common bile duct (to locate and remove gallstones, for instance) you should report only 47564 (Laparoscopy, surgical; cholecystectomy with exploration of common duct). The National Correct Coding Initiative bundles 47563 (... cholecystectomy with cholangiography) into 47564. The edit pair includes a -0- modifier indicator, meaning that you may never override the edit. Payers will always include the work involved in 47563 into 47564.