CPT® Code 43260

Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic procedure that utilizes an endoscope to examine the pancreatic and biliary ducts, which are responsible for draining the pancreas, liver, and gallbladder. This procedure is particularly focused on identifying issues within the bile ducts, which can include a variety of conditions affecting the liver, gallbladder, and pancreas. During an ERCP, the physician passes an endoscope through the patient's esophagus and stomach, advancing it into the duodenum, where the pancreatic duct and common bile duct converge at a location known as the ampulla of Vater, located at the major duodenal papilla. Once the endoscope is in place, a smaller catheter is introduced through the scope to cannulate the ampulla of Vater. Following this, contrast dye is injected into the ducts, allowing for visualization of the common bile duct, biliary tract, gallbladder, and pancreas via X-ray imaging. This imaging is crucial for detecting potential abnormalities such as gallstones, strictures, leaks, scarring, or malignancies. Additionally, the procedure may involve the advancement of the catheter over a guidewire into the common duct, biliary tract, gallbladder, and/or pancreas to facilitate the collection of cellular specimens through brushing or washing techniques. It is important to note that if tissue samples (biopsies) are obtained during the procedure, the appropriate code to use is 43261.