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Shortcut to learn about ERCP cpt code in Radiology

ERCP CPT Code introduction

Shortcut to learn about ERCP cpt code in Radiology

ERCP CPT Code is very common while coding radiology procedures. ERCP stands for endoscopic retrograde cholangiopancreatography (ERCP). The exam is performed using an endoscope and taking x rays simultaneously. These codes are coded both in surgical and diagnostic coding. ERCP CPT Code is easy to learn if we know the anatomy and how the procedure is performed. The endoscope is inserted through the mouth into the oropharynx, esophagus, stomach, and into the small intestine until it reaches the point where the ducts from the pancreas and gallbladder drain into the duodenum. The pancreatic ducts (pancreas) and bile ducts (gallbladder) are studied in ERCP exam. Once the cannula reaches to the examine area, dye is injected and X rays are taken.

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Need for ERCP cpt code procedure

The exam is done to find any symptoms or disorders related to liver, bile ducts and pancreas. It helps in finding any persistent pain in abdominal region. Gallstones can be easily diagnosed with ERCP exam. Inflammation like pancreatitis and infection like cholangitis of abdomen area can also be treated nicely with this exam. ERCP exam hence helps in solving many harmful disorders of abdominal region. Let’s check out the ERCP CPT code used in medical coding:

74328- Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation

74329- Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation

74330- Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation

These are the radiological supervision and interpretation (S&I) codes. The above codes are used with surgical codes (43260-43272 [43274, 43275, 43276, 43277,43278]), if only we have code S&I code only,  we have to code above codes with 26 modifier for professional component.

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ERCP CPT codes in Surgery

In Surgery, ERCP CPT codes are used  to report stenting procedures. For example, CPT code 43268 and 43269 is used for ERCP procedure for insertion of tube, stent or removal of Foreign body. Below are their details code description.

43268 – Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde insertion of tube or stent into bile or pancreatic duct

43269 – Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic retrograde removal of foreign body and/or change of tube or stent

CPT code 43268 can be coded twice if two stents are placed in the common bile duct extending to left hepatic duct and right hepatic duct using 59 or X{EPSU} modifiers. But for multiple stents placed side by side in common bile duct, we are allowed to report 43268 only once.

For CPT code 43269, when two stents are removed and only one stent is replaced, 43269 would be reported only once.

Details about ERCP CPT Code

The ERCP CPT codes are less in number. The codes are given on the basis of the anatomic area. The CPT codes are only three and the codes are easy to code. There are separate codes for ERCP procedure done on Bile duct (74328) and pancreatic duct (74329). Also, when the ERCP exam is done to evaluate both bile and pancreatic duct, we have a combined code 74330.Most common indication for ERCP procedures are

Abdominal Pain

Chronic Pancreatitis

Jaundice

Gallstones

Biliary Stricture

Hope this article helps you to learn about ERCP CPT Code and its basics. Please share if you like the article.