CPT® Code 47533

Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external

The CPT® Code 47533 refers to the procedure of placing a percutaneous biliary drainage catheter for external drainage. This procedure is typically indicated when there is a blockage in the bile ducts due to conditions such as stenosis, impacted stones, or tumors. The process begins with the preparation of the skin at the insertion site, which is usually located over the right midaxillary line below the tenth rib for access to the right hepatic lobe or over the epigastrium for access to the left hepatic lobe. A long, thin, flexible needle is then inserted through the skin into the liver and advanced into the bile duct. To confirm the correct placement of the needle, a small amount of contrast medium is injected. Following this, a guidewire is passed through the needle into the bile duct, allowing for the needle to be removed. If diagnostic cholangiography is performed, an angiography catheter is introduced over the guidewire, and dye is injected into the bile ducts, enabling visualization on X-ray. Additional radiographic images are captured as the contrast flows through the bile ducts into the small intestine. The procedure may also involve probing the bile duct and dilating any strictures before the biliary drainage catheter is inserted over the guidewire. The catheter is designed to facilitate the drainage of bile externally, with the end of the tube exiting the skin and connected to a collection bag. This code encompasses the entire process, including imaging guidance, contrast injection, and all associated radiological supervision and interpretation necessary for the successful placement of the biliary drainage catheter.