However, inflammation, adhesions, and anatomic difficulty continue to challenge the use and safety of this approach in a small number of patients. This deduction incorrectly focuses on the limited portion of the procedure performed extracorporeally (specimen extraction and/or creation of anastomosis) and fails to recognize that the beginning, end, and overwhelming majority of the procedure is performed intracorporeally with laparoscopic camera guidance under pneumoperitoneum. CPT Code For Laparoscopic Cholecystectomy - PeekaPoo - S Although some surgeons try to bill both services by appending modifier -53 (discontinued procedure) to the lap chole with cholangiogram (47563, or 47562 if no cholangiogram was performed), this is incorrect because 47605 and 47563 describe different ways of performing the same service. The cystic duct and the cystic artery are identified, clipped with tiny titanium clips and cut. Find the trace of the plane in the given coordinate plane. Gallbladder stones could move into the common bile duct after gallbladder contraction, causing acute cholecystitis. The different types of imaging that gastroenterologists order to detect cholecystitis are: Cholecystitis requires hospitalization. If you feel some of our contents are misused please mail us at medicalbilling4u at gmail dot com. Tip 1: Read the Entire Operative Report Sometimes, a laparoscopic cholecystectomy will be converted to an open cholecystectomy for technical reasons or safety. prealgebra. The surgeon inflates the abdominal cavity with carbon dioxide to create a working space. Laparoscopic Cholecystectomy Converted to Open: Create an . Two key points have been established. The edit includes a 0 indicator, meaning that no override is possible using modifier -59 (distinct procedural service). What should I not eat with no gallbladder? Some surgeons routinely include cholangiography (many surgeons have been trained to do so), whereas others may perform the service only for specific indications, such as an elevated liver function study, an ultrasound that shows an enlarged common bile duct or because the patient has a history of gallstone pancreatitis. For example, cholangiograms are frequently performed in conjunction with cholecystectomies (both laparoscopic and open), but occasionally the former procedure is not listed at the top of the operative report. A total of 310 patients (5.2%) had had their cholecystectomies converted to an open procedure. What is the CPT code for cholecystectomy? For the Cy2013 PFS, these codes are correctly ranked. Furthermore, carriers in some states may only pay for physician S&I performed by a certified radiologist. It is incorrect to report a code for ileostomy or jejunostomy (44310 or 44187) with a partial colectomy code (for example, 44145 or 44207) for this procedure, as doing so would be unbundling. This confusion likely involves use of International Classification of Diseases Tenth Revision Procedure Coding System (ICD-10-PCS) codes, which classify procedures performed in the inpatient setting. In order to obtain prior authorization for procedure(s), choose appropriate InterQual SmartSheet(s) listed below. caffeine, which is often in tea, coffee, chocolate, and energy drinks. The study population was identified by CPT code 47562, 47563, and 47564 utilizing a centralized electronic medical . As a result, the surgeon converts to an open procedure. 5 Can a laparoscopy be converted to a cholecystectomy? This pain may last for a few days. The ICD-10-PCS is a procedure classification published by the United States for Then divide the terminal ileum 5 cm proximal to the CD with a stapling device. PMC Cholangiography is often (but not always) performed when a gallbladder is removed to help the surgeon better determine the patients anatomy and to check for gallstones in the common bile duct, says Tray Dunaway, MD, FACS, a general surgeon and evaluation and management coding author in Camden, S.C. Common uncontrolable risk factors for gallstone disorders include being female, being 60 years or older, being of Native American or Mexican-American descent, and family history. ** Cholecystectomy, Laparoscopic, Cholangiogram Intraoperative with Laparoscopic Cholecystectomy, ** Cholecystectomy, Open, Cholangiogram Intraoperative with Open Cholecystectomy. The camera illuminates the surgical field and sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the organs and tissues. In this invasive procedure, the technique of laparoscopy is used and gall bladder is removed by making 4 to 5 small incisions than a long cut. Reasons for conversion, surgeon's preoperative indications, and specimen pathologic results were documented. PDF ICD-10-PCS Official Guidelines for Coding and Reporting So if a laparoscopic biopsy of the liver is performed at the same time as another laparoscopic procedure, unlisted code 47379 should be reported, as there is no CPT code for a laparoscopic liver biopsy. Eighty-six patients (2.6%) required conversion to open cholecystectomy during the study period. . 2023 ICD-10-PCS Procedure Code 0FT40ZZ - ICD10Data.com Antibiotics | Free Full-Text | Acute Cholecystitis from Biliary In some cases, however, surgeons can bill for significant extra work and time by appending modifier -22 to the appropriate procedure code. In one cross-sectional study, the conversion from laparoscopic to open surgery for cholecystectomy was only 0.6% (Yuda Handaya et al., 2021). Coders have referenced each of these ICD-10-PCS approaches to claim that laparoscopic abdominal procedures that include a minor incision for hand-assistance laparoscopy (HAL) or for extraction or exteriorization of the bowel should be coded as an open procedure. The authors concluded that laparoscopic cholecystectomy can be performed as true outpatients within hours of completion of the procedure. Chicago, IL 60611, Laparoscopic colectomy description of work, www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-PCS.html. Verified answer. Just because a procedure was converted from laparoscopic to open does not automatically justify the use of modifier -22, she explains. ICD-10-PCS Coding Demonstration of a Laparoscopy to Open Converted 2023 ICD-10-CM Diagnosis Code Z53.31 - ICD10Data.com Question 12.Question : (TCO 6) If a patient has a laparoscopic cholecystectomy converted to an open cholecystectomy, the ICD-10-PCS coding guidelines require that the coder must code: Student Answer: open resection of the gallbladder percutaneous endoscopic inspection both percutaneous endoscopic inspection and open . Using either a Veress needle or Hasson technique, the abdominal cavity is entered. Listing of a code in this guideline does not imply that the service described by the code is a covered or non-covered health service. See the appropriate diagnosis codes below. j!9[",ge`Ze`@ q/= Epub 2009 May 27. Additionally, CPT code 47563 was reviewed in October 2010. Coding for Gall Bladder Disease and Cholecystectomy Answered 1 year ago. Because cholangiography is routinely performed in conjunction with a lap chole, some surgeons forget to mention cholangiography at the top of the operative report, says Elaine Elliott, CPC, an independent general surgery coding specialist in Stuart, Fla. Appendectomy or laparoscopic appendectomy CPT code (s): 44950, 44955, 44960, 44970 Cholecystectomy or laparoscopic cholecystectomy. For example, the ICD-10-PCS open endoscopic approach is defined as cutting through the skin or mucous membrane and any other body layers necessary to expose a body part, and introduction of instrumentation to reach and visualize the site of the procedure. A second example is the open with percutaneous endoscopic assistance approach defined as cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure, and entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to aid in the performance of the procedure.. Radiology tests provide valuable information regarding the location of gallstones, as well as size and effect on organ function. The ACS, ASCRS, and SAGES agree that the procedures described as open in the CPT code set have always clearly meant that a laparotomy was performed and that the procedures described as laparoscopic have always clearly meant that the beginning, end, and most or all of the work in between was performed using trocars and laparoscopic instruments. The https:// ensures that you are connecting to the This is reflected in the relative value units assigned to each procedure: 47562, 18.17; 47563 19.59; 47564, 23.59. CPT code 47563 describes a diagnostic laparoscopy and surgical removal of the gallbladder with the additional work of an intraoperative cholangiography. For the "ICD-10 Coding--Bonnie Altus" playlist, go to:https://www.youtube.com/playlist?list=PLRfHZ9wXKs6dJTxMF8y08sxGupC5AAj_PBonnie Altus (MS,RHIA,CHPS) is . PDF 2022 Billing and Coding Guide - Medtronic FOIA Guidelines for Billing With Modifier -22 We use cookies to ensure that we give you the best experience on our website. Laparoscopic cholecystectomy is minimally invasive surgery to remove the gallbladder. Verified questions. Six B. Even more time may be required if the surgeon notices a perforation of the small intestine while adhesion lysis is being performed. help the operating surgeon code the surgery as simple or difficult. Upper abdominal pain is the most common symptom of acute cholecystitis. 2022 Apr;26(4):837-848. doi: 10.1007/s11605-022-05249-5. Three Tips Help Optimize Billing for Laparoscopic Cholecystectomy, In some situations, a general surgeon may receive additional reimbursement for a laparoscopic cholecystectomy (lap [], Reason for Excision of Coccyx Determines Correct Code, "When a coccygeal decubitus ulcer is excised or debrided, the patients coccyx may also be [], Flexible Sigmoidoscopy With Prior Colectomy, Question: Our surgeon performed a flexible sigmoidoscopy through the rectum and into the small bowel, [], The March issue of General Surgery Coding Alert incorrectly stated that 11044 (debridement; skin, subcutaneous [], Partial Colectomy Code Describes Ileocolostomy, Question: A presumptive diagnosis of acute appendicitis was made on a patient in the emergency [], Question: How should I code for the excision of a 2-cm lipoma on the forehead [], Question: I have always thought that multiple procedures performed the same day on the same [], Endoscopy, Colonoscopy During Same Session, Question: The January 2001 General Surgery Coding Alert, p. 3, provides an example of the [], Subsequent Observation Day Billed as Established Outpatient Visit, Question: My physician admitted a female patient for observation with left lower quadrant abdominal pain, [], Copyright 2023. Although the CPT descriptor includes the term colostomy, the Medicare physician fee schedule work relative value unit(RVU) for this code is based on creation of either a colostomy or an ileostomy. KarenZupko & Associates, Inc. 2023 | All Rights Reserved. Technical modifications to decrease injury rates have been suggested. In all three situations, no additional codes may be billed. One of the most common abdominal surgical procedures is cholecystectomy. 3 What is the root operation for laparoscopic cholecystectomy? As the surgeon moves deeper (toward the cystic duct and artery), however, the patients anatomy becomes indiscernible due to a solid mass of inflammation. The surgeon, increasingly concerned about proceeding under laparoscopic guidance only, converts to an open approach. Solution. Partnering with an experienced medical coding outsourcing company can ensure accurate reporting of gastroenterology procedures. In this context, annotation back-references refer to codes that contain: "Present On Admission" is defined as present at the time the order for inpatient admission occurs conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA. They may inadvertently add things they didnt do or leave out things they did. In the CY 2013 PFS, CMS identified CPT codes 47562 and 47563 as potentially misvalued based on a public commenter that questioned the rank order. Z53.31 Laparoscopic procedure converted to open Z53.32 Thoracoscopic procedure converted to open Z53.33 Arthroscopic procedure converted to open Z53.39 Other specific procedure converted to open A laparoscopic colectomy is performed with most of the procedure completed intracorporeally, including, but not limited to, a diagnostic laparoscopy, mobilization of the intestine, vascular ligation, and bowel transection. S syllingk Guest Messages For more information about the workshops, including details for registering for a 2019 class, visit the ACS website. Would you like email updates of new search results? Bingener-Casey J, Richards ML, Strodel WE, Schwesinger WH, Sirinek KR. Available at: www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-PCS.html. Small-incision Open Cholecystectomy or Laparoscopic Cholecystectomy for Spending an extra 20 or 30 minutes is probably not enough, Elliott says, because fees are based on the average time it takes to perform the procedure. Reasons for conversion from laparoscopic to open cholecystectomy: a 10 Scenario #2. If this same procedure was performed laparoscopically, the correct code to report would be 44208,Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy. Again, modifier -22 should be appended to indicate that significant additional work and time were required to perform the procedure. Difficult Laparoscopic Cholecystectomy Predictors and its Significance: Our Experience. Verified. Z53.31 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The ACS also provides clarification on coding in such circumstances in its June 1, 2018 bulletin. 47562 laparoscopy, surgical; cholecystectomy; A laparoscopic cholecystectomy may be converted to an open cholecystectomy. HCFA policy, meanwhile, states that only one physician may be paid for performing radiological S&I. Extraction of a specimen and/or creation of anastomosis does not constitute the majority of the procedure. Note: Although some carriers may be paying these claims with modifier -53 appended, such billing is nonetheless incorrect. CPT 81479 oninvasive Prenatal Testing for Fetal Aneuploidies, Top 13 denials in RCM and how to prevent the denials, Critical care codes Usage , Time, Documentation, Medical necessity condition with example, CPT Code 99201, 99202, 99203, 99204, 99205 Which code to USE. alcoholic drinks, including beer, wine, and spirits. A review of published data from the previous two decades was also conducted for comparison of contemporary versus historical reasons for intraoperative conversion. (2021). See the appropriate diagnosis codes below. Please enable it to take advantage of the complete set of features! CPT Code: 47562, 47563 Cholecystectomy is the surgical removal of the gallbladder. Warchaowski , uszczki E, Bartosiewicz A, Dere K, Warchaowska M, Oleksy , Stolarczyk A, Podlasek R. Int J Environ Res Public Health. Free market-loving, price-displaying, state-of-the-art, AAAHC accredited, doctor owned, multispecialty surgical facility in central OK. Laparoscopic cholecystectomy requires several small incisions in the abdomen to allow the insertion of operating ports, small cylindrical tubes approximately 5 to 10 mm in diameter, through which surgical instruments and a video camera are placed into the. After insufflation with CO2(carbon dioxide), insert the laparoscope and perform a visual inspection of the abdominal contents. This may represent a different session, different procedure or operation, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries, Code Description0FJB4ZZ Inspection of Hepatobiliary Duct, Percutaneous Endoscopic Approach0FT44ZZ Resection of Gallbladder, Percutaneous Endoscopic ApproachBF10YZZ Fluoroscopy of Bile Ducts using Other ContrastBF50200 Other Imaging of Bile Ducts using Fluorescing Agent, Indocyanine Green Dye, IntraoperativeBF502Z0 Other Imaging of Bile Ducts using Fluorescing Agent, IntraoperativeBF52200 Other Imaging of Gallbladder using Fluorescing Agent, Indocyanine Green Dye, IntraoperativeBF522Z0 Other Imaging of Gallbladder using Fluorescing Agent, IntraoperativeBF53200 Other Imaging of Gallbladder and Bile Ducts using Fluorescing Agent, Indocyanine Green Dye, IntraoperativeBF532Z0 Other Imaging of Gallbladder and Bile Ducts using Fluorescing Agent, Intraoperativ. This resulted in a rank order anomaly for 2012(47562 wRVU = 11.87; 47563 wRVU = 11.47). A . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). For example, if the surgeon must perform extensive lysis of adhesions, 44200 (laparoscopy, surgical; enterolysis [freeing of intestinal adhesion] [separate procedure]) cannot be billed in addition to 47562 because the codes are bundled in the national Correct Coding Initiative (just as 44005, the code for open lysis of adhesions, is bundled to 47600, the open cholecystectomy code). All our content are education purpose only. A retrospective review of medical records was undertaken to identify all laparoscopic converted to open cholecystectomy performed at a single center over a 2-year period. What is the CPT code for a cholangiogram? Then mobilize the terminal ileum and ascending colon by incising the lateral peritoneal attachments. Other Policies and Guidelines may apply. Between May 2008 and April 2010, 3371 laparoscopic cholecystectomies were performed at Greenville Hospital System University Medical Center. cpt code for laparoscopic cholecystectomy converted to open Accomplish the anastomosis between the ileum and the remaining ascending colon by stapling with a gastrointestinal anastomosis stapler to join the two limbs of bowel. Given the success with this operative approach, laparoscopic cholecystectomy is considered the gold standard for the surgical treatment of gallstone disease. Reasons for conversion from laparoscopic to open cholecystectomy: a 10-year review. Medicare Contractor Medical Directors (CMDs) propose that CPT codes 47560, 47562, and 47563 are potentially misvalued because the more extensive code has lower work RVUs than the less extensive codes.4 The ACS disagrees and believes that the CMDs may have overlooked the fact that 47560 (Laparoscopy, surgical; with guided transhepatic cholangiography, without biopsy) has a 000-day global period. This study aims to evaluate the reasons for conversion of this operation in the current era of laparoscopic surgery. Close the defect in the mesentery using an absorbable running stitch, and then place the bowel back within the abdominal cavity. Conversion to open cholecystectomy . Bethesda, MD 20894, Web Policies The gallbladder fundus is identified, grasped, and retracted superiorly. 8596 E. 101st Street, Suite HTulsa, OK 74133, CPC: Director of Revenue Cycle Management, CPC: Senior Solutions Manager: Practice and RCM, Outsource Strategies International. official website and that any information you provide is encrypted 47562 Laparoscopy, surgical; cholecystectomy47563 Laparoscopy, surgical; cholecystectomy with cholangiography47564 Laparoscopy, surgical; cholecystectomy with exploration of common duct. endstream endobj startxref Seven C. Four D. Five, The fifth character of the ICD-10-PCS code is for the approach, which identifies the method used to reach the . Cholecystectomy is the surgical removal of the gallbladder. It appears that national coder websites and coder discussion boards have been providing incorrect coding guidance, which may represent the root cause of the coding confusion. CPT code 47562 describes a diagnostic laparoscopy and surgical removal of the gallbladder. . Note: If the patient is brought back to the operating room for repair of the complication, modifier -78 (return to the operating room for a related procedure during the postoperative period) should be attached to the appropriate procedure code. Use code 47563 for a laparoscopic cholecystectomy with cholangiography. This coding approach is incorrect even in comparison with ICD-10-PCS, which defines an open procedure as cutting through the skin and mucous membrane and any other body layers necessary to expose the site of the procedure. The extension of the trocar incision or a separate small incision to exteriorize the bowel is not an open dissection that exposes the site of the procedurethe abdominal cavity. Surgical procedures StatisticsThe goal of the surgical cross-over exhibits was to identify total volume, spending, price per procedure, and differences in cost across settings of care for procedures that can be performed either in hospital inpatient or hospital outpatient settings. . 2008). As long as you continue on and successfully complete the service, you bill that service only. Laparoscopic cholecystectomy is a covered surgical procedure in which a diseased gall bladder is removed through the use of instruments introduced via cannulae, with vision of the operative field maintained by use of a high-resolution television camera-monitor system (video laparoscope). sharing sensitive information, make sure youre on a federal perform extensive lysis of adhesions; You may appropriately bill the extra time using modifier -22. ICD-10-PCS Chapter 1 and 2 quiz Flashcards | Quizlet Use another thoracoabdominal stapler to close the remaining enterotomy and colotomy. Then close the fascial defect in two layers and insufflate the abdomen again to irrigate and inspect. Accessed April 17, 2019. Occasionally a lap chole requires significant additional effort and time than routinely necessary. In the Unites States, 90% are performed laparoscopically. When modifier -22 is attached to the open cholecystectomy to note additional effort and time, this V code helps explain to the carrier why the additional payment is being claimed. This type of surgery requires meticulous surgical skill, but in straightforward cases, it can be done in about an hour. Dose and administration time of indocyanine green in near-infrared Code 55520, Excision of lesion of spermatic cord (separate procedure),is a separate procedure. Coding tip: When a procedure that is designated as a separate procedure is carried out independently or considered to be unrelated or distinct from other procedures/services provided at that time, it may be reported by itself, or in addition to other procedures/services by appending modifier 59 to the specific separate procedure code to indicate that the procedure is not considered to be a component of another procedure, but is a distinct, independent procedure. Inpatient procedure costs include the hospital payment for the entire stay associated with the surgery. Whenever a closed procedure (laparoscopic, arthroscopic, endovascular) is converted to an open procedure only the open procedure may be reported. However, only one code applies to laparoscopic appendectomy (44970), and it is used to report a laparoscopic appendectomy for either scenario; with rupture or without rupture. The physicians operative report should include everything done to care for the patient. 2020 Oct 18;17(20):7571. doi: 10.3390/ijerph17207571. Before This is performed after laparoscopic cholecystectomy (gall bladder removal) for evaluation of bile excretion in small intestine. To a question on a laparoscopic biopsy of the liver is performed at the same time as laparoscopic cholecystectomy, the article advises: If these procedures were performed via an open approach, code 47600 (open cholecystectomy) would be reported with code 47001, Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure), or code 47100, Biopsy of liver, wedge, as appropriate.. Going beyond just getting the job done, we can help create sustainable improvement as part of your medical billing team. American Hospital Association ("AHA"). The surgery involves a few small incisions, and most people go home the same day and soon return to normal activities. Let's ra, With the large amounts of clinical documentation a, Arterial embolization is a minimally-invasive proc, Need professional support to meet those medical bi, February is observed as American Heart Month, Streamline the billing process and prevent claim d, Cracking the Code: Understanding CDT Codes for Dental Bridges, Dental Billing Codes for Reporting Osseous Surgery, K80.00 (calculus of gallbladder with acute cholecystitis without obstruction, K80.01 (calculus of gallbladder with acute cholecystitis with obstruction, K80.10 (calculus of gallbladder with chronic cholecystitis without obstruction), K80.11 (calculus of gallbladder with chronic cholecystitis with obstruction), K80.12 (calculus of gallbladder with acute and chronic cholecystitis without obstruction), K80.13 (calculus of gallbladder with acute and chronic cholecystitis with obstruction), K80.18 (calculus of gallbladder with other cholecystitis without obstruction), K80.19 (calculus of gallbladder with other cholecystitis with obstruction), K80.20 (calculus of gallbladder without cholecystitis without obstruction), K80.21 (calculus of gallbladder without cholecystitis with obstruction), K80.30 (calculus of bile duct with cholangitis, unspecified, without obstruction, K80.31 (calculus of bile duct with cholangitis, unspecified, with obstruction), K80.32 (calculus of bile duct with cholangitis, without obstruction), K80.33 (calculus of bile duct with cholangitis, with obstruction), K80.34 (calculus of bile duct with chronic cholangitis, without obstruction), K80.35 (calculus of bile duct with chronic cholangitis, with obstruction), K80.36 (calculus of bile duct with acute and chronic cholangitis, without obstruction), K80.37 (calculus of bile duct with acute and chronic cholangitis, with obstruction), K80.40 (calculus of bile duct with cholecystitis, unspsecified without obstruction), K80.41 (calculus of bile duct with cholecystitis, unspecified, with obstruction), K80.42 (calculus of bile duct with acute cholecystitis without obstruction), K80.43 (calculus of bile duct with acute cholecystitis with obstruction), K80.44 (calculus of bile duct with chronic cholecystitis without obstruction), K80.45 (calculus of bile duct with chronic cholecystitis with obstruction), K80.46 (calculus of bile duct with acute and chronic cholecystitis without obstruction), K80.47 (calculus of bile duct with acute and chronic cholecystitis with obstruction), K80.50 (calculus of bile duct without cholangitis or cholecystitis without obstruction), K80.51 (calculus of bile duct without cholangitis or cholecystitis with obstruction), K80.60 (calculus of gallbladder and bile duct with cholecystitis, unspecified, without obstruction), K80.61 (calculus of gallbladder and bile duct with cholecystitis, unspecified, with obstruction), K80.62 (calculus of gallbladder and bile duct with acute cholecystitis without obstruction), K80.63 (calculus of gallbladder and bile duct with acute cholecystitis with obstruction), K80.64 (calculus of gallbladder and bile duct with chronic cholecystitis without obstruction), K80.65 (calculus of gallbladder and bile duct with chronic cholecystitis with obstruction), K80.66 (calculus of gallbladder and bile duct with acute and chronic cholecystitis without obstruction), K80.67 (calculus of gallbladder and bile duct with acute and chronic cholecystitis with obstruction), K80.7 (calculus of gallbladder and bile duct without cholecystitis), K80.70 (calculus of gallbladder and bile duct without cholecystitis without obstruction), K80.71 (calculus of gallbladder and bile duct without cholecystitis with obstruction), K80.80 (other cholelithiasis without obstruction), K80.81 other cholelithiasis with obstruction), K81.2 (acute cholecystitis with chronic cholecystitis), 47562 (laparoscopic cholecystectomy without cholangiography), 47563 (laparoscopic cholecystectomy with cholangiography), 47564 (laparoscopic cholecystectomy with exploration of the common bile duct), 47600 (cholecystectomy without cholangiography), 47605 (cholecystectomy with cholangiography), 47610 (cholecystectomy with exploration of the common bile duct), 47612 (cholecystectomy with exploration of common bile duct; with choledochoenterostomy), 47620 (cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography).
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