What is Laparoscopic Cholecystectomy and How to Code It in CPT?
Laparoscopic cholecystectomy is a surgical procedure that involves removing the gallbladder through small incisions in the abdomen. The gallbladder is a small organ that stores bile, a fluid that helps digest fats. Sometimes, the gallbladder can develop stones or inflammation that cause pain and other complications. Laparoscopic cholecystectomy is a minimally invasive technique with several advantages over open surgery, such as less pain, faster recovery, and lower risk of infection.
What are the indications and contraindications of laparoscopic cholecystectomy?
Laparoscopic cholecystectomy is indicated for patients with symptomatic gallstones or acute cholecystitis (gallbladder inflammation). It may also be performed for patients who have chronic cholecystitis (recurrent inflammation of the gallbladder), biliary dyskinesia (abnormal movement of the bile ducts), or polyps or tumors of the gallbladder.
Laparoscopic cholecystectomy is contraindicated for patients who have severe cardiopulmonary disease, coagulopathy (bleeding disorder), portal hypertension (high blood pressure in the liver), or previous extensive abdominal surgery. It may also be contraindicated for patients who have acute pancreatitis (inflammation of the pancreas), choledocholithiasis (stones in the common bile duct), or suspected malignancy of the gallbladder.
How to code laparoscopic cholecystectomy in CPT?
CPT is a system of codes that describes medical procedures and services for billing and documentation purposes. Laparoscopic cholecystectomy is classified under the category of laparoscopy, surgical; cholecystectomy (47562-47564). The specific code for laparoscopic cholecystectomy depends on whether it is performed with or without cholangiography (imaging of the bile ducts) or exploration of the common duct. Here are some examples of laparoscopic cholecystectomy codes in CPT:
| Code | Description |
|---|---|
| 47562 | Laparoscopy, surgical; cholecystectomy |
| 47563 | Laparoscopy, surgical; cholecystectomy with cholangiography |
| 47564 | Laparoscopy, surgical; cholecystectomy with exploration of common duct |
When coding laparoscopic cholecystectomy in CPT, it is essential to specify the modifiers if applicable. For example, if laparoscopic cholecystectomy is performed on both sides, you should append modifier 50 (bilateral procedure) to the code. If laparoscopic cholecystectomy is converted to open surgery due to complications or technical difficulties, you should append modifier 22 (increased procedural services) to the code.
In some cases, laparoscopic cholecystectomy may be performed with intraoperative choledochoscopy (endoscopy of the bile ducts). This is an add-on procedure that requires an additional code. The code for intraoperative choledochoscopy is 47550 (biliary endoscopy, intraoperative [choledochoscopy]). This code should be listed separately in addition to the code for laparoscopic cholecystectomy.
Conclusion
Laparoscopic cholecystectomy is a surgical procedure that involves removing the gallbladder through small incisions in the abdomen. It is indicated for patients who have symptomatic gallstones or acute or chronic cholecystitis. It can be coded in CPT using codes from the category of laparoscopy, surgical; cholecystectomy (47562-47564) and specifying the modifiers if applicable. If laparoscopic cholecystectomy is performed with intraoperative choledochoscopy, an additional code (47550) should be used.
References
(1) CPT CODE 47562, 47563, 47564 – LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY.
(2) 2021 Coding & Payment Quick Reference – Boston Scientific.
(3) 2023 Coding & Payment Quick Reference – Boston Scientific.
(4) Icd-10 procedure code for laparoscopic cholecystectomy.
(5) CPT code for laparoscopic cholecystectomy converted to open.