CPT® Code 74363

Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation

Percutaneous transhepatic dilation of a biliary duct stricture is a minimally invasive procedure aimed at alleviating obstructions within the bile ducts. This procedure involves the use of a flexible fiberoptic endoscope, which is inserted through a T-tube or other access tract to visualize the bile ducts. The primary goal is to inspect the ducts for any signs of disease or abnormalities that may be causing the stricture. Once the endoscope reaches the site of the stricture, a specialized balloon catheter is introduced through a separate channel in the endoscope. The balloon is carefully positioned within the narrowed segment of the duct and inflated to widen the stricture. This inflation is typically performed for a brief duration, after which the balloon is deflated, allowing for re-evaluation of the stricture. The inflation and deflation process may be repeated multiple times to achieve optimal dilation of the stricture. In cases where multiple strictures are identified, the procedure can be performed at additional sites as necessary. If a stent is indicated, it is advanced through the endoscope to the stricture site in its collapsed form and then deployed to maintain the duct's patency once properly positioned. Following the dilation and potential stent placement, the physician conducts a thorough evaluation of the bile ducts beyond the stricture to ensure there are no further complications. As the endoscope is withdrawn, the bile ducts are inspected once more for any signs of injury or additional disease. It is important to note that the radiological supervision and interpretation associated with this procedure is reported separately using CPT® Code 74360.