Radiology Coding Alert

Question: What's the difference between the surgical procedures that require RS&I codes 75980 and 75982?


Washington Subscriber

Answer: Report CPT 75980 (Percutaneous transhepatic biliary drainage with contrast monitoring, radiological supervision and interpretation) with 47510 (Introduction of percutaneous transhepatic catheter for biliary drainage).

During the procedure described by 47510 (commonly called "external drainage"), the physician introduces a catheter into the liver, positioned above the level of the obstruction, allowing the bile to drain outside the body. He uses fluoroscopy and contrast for guidance, such as visualizing the intrahepatic bile ducts.

Report 75982 (Percutaneous placement of drainage catheter for combined internal and external biliary drainage or of a drainage stent for internal biliary drainage in patients with an inoperable mechanical biliary obstruction, radiological supervision and interpretation) with 47511 (Introduction of percutaneous transhepatic stent for internal and external biliary drainage).
 
The procedure described by 47511 ("internal-external drainage") also requires the physician to introduce a catheter into the liver, but the physician places the catheter past the obstruction, allowing bile to drain into the small intestine. Part of the catheter may also extend outside the body.
 
The answers for You Be the Coder and Reader Questions were reviewed by Jackie Miller, RHIA, CPC, senior consultant with Coding Strategies Inc. in Powder Springs, Ga.; and Gary S. Dorfman, MD, FACR, FSIR.