Radiology Coding Alert
Find the Proper Fistula Code
West Virginia Subscriber
Answer: You should code for the injection procedure and the radiologic supervision and interpretation with this report.
For the injection, you know that the patient had a cholecystotomy tube prior to this procedure, and this tube was where the physician injected the Isovue 300. Choose 47505 (Injection procedure for cholangiography through an existing catheter [e.g., percutaneous transhepatic or T-tube]).
This code conveniently directs you to use 74305 (Cholangiography and/or pancreatography; through existing catheter, radiological supervision and interpretation) for radiological supervision and interpretation.
The report indicates a fistula--an abnormal duct or passage--between the gallbladder and jejunum. Based on the results, your ICD-9 index directs you to 575.5 (Fistula of gallbladder) for a gallbladder fistula.
Key: A note under 575.5 indicates that it includes cholecystoenteric fistulas (fistulas between the gallbladder and the intestine). Result: Code 575.5 is the correct choice for this particular fistula.
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