Please reach out and we would do the investigation and remove the article. For example, the surgeon attempts to remove an inflamed gallbladder laparoscopically. Radiology tests provide valuable information regarding the location of gallstones, as well as size and effect on organ function. 3 What is the root operation for laparoscopic cholecystectomy? Colectomy codes are identified as either open or laparoscopic. An example of this situation is a failed laparoscopic cholecystectomy, followed by an open cholecystectomy at the same session. A total of eight patients were admitted to the hospital following postanesthesia care, six of these eight patients were discharged on the first postoperative day. 47562 laparoscopy, surgical; cholecystectomy; Inpatient Choledocholithiasis Management: a Cost-Effectiveness Analysis of Management Algorithms. Background One of the most severe complications in laparoscopic cholecystectomy (LC) is intraoperative bile duct injury (BDI). Note: If the patient is brought back to the operating room for repair of the complication, modifier -78 (return to the operating room for a related procedure during the postoperative period) should be attached to the appropriate procedure code. In many instances, however, the surgeons billing for S&I may not be that straightforward. As the surgeon moves deeper (toward the cystic duct and artery), however, the patients anatomy becomes indiscernible due to a solid mass of inflammation. Thats why it is important to read the body of the operative note. procedure converted to open procedure, to show the conversion to open procedure. It is a common treatment of symptomatic gallstones and other gallbladder conditions. Surgical Modifiers: How Do They Impact Reimbursement? The patient underwent a laparoscopic cholecystectomy, but the surgeon also did an open cholangiogram. The American College of Surgeons (ACS), the American Society of Colon and Rectal Surgeons (ASCRS), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) have recently received inquiries about correct Current Procedural Terminology (CPT*) coding for colectomy procedures. View full document. Biliary tract injuries during laparoscopic cholecystectomy: three case reports and literature review. For this clinical scenario, report only the hernia repair code 49505 (see Table 4, page 44). Centers for Medicare & Medicaid Services. Just because a procedure was converted from laparoscopic to open does not automatically justify the use of modifier -22, she explains. How do I report removal of a lipoma of the spermatic cord and repair of a reducible inguinal hernia performed at the same time, through the same incision? For example, cholangiograms are frequently performed in conjunction with cholecystectomies (both laparoscopic and open), but occasionally the former procedure is not listed at the top of the operative report. When you buy a model home do you get the furniture? Rangel-Olvera G, Alanis-Rivera B, Trejo-Suarez J, Garcia-Martin Del Campo JN, Beristain-Hernandez JL. This site needs JavaScript to work properly. People who have had gallbladder removal surgery should avoid certain foods, including: The incision and your abdominal muscles may ache, especially after long periods of standing. %PDF-1.6 % Sometimes, a laparoscopic cholecystectomy will be converted to an open cholecystectomy for technical reasons or safety. Going beyond just getting the job done, we can help create sustainable improvement as part of your medical billing team. Divide the ascending colon in a similar fashion. Step 1. If significant additional work or time is required to lyse adhesions, repair a complication or convert the procedure from laparoscopic to open, modifier -22 (unusual procedural services) can be appended to the appropriate code and additional payment claimed; or This is because open surgery leaves the patient more prone to infection. The CPT codes for cholecystectomy (outpatient) effective January 1, 2018 are as follows: Awareness of issues such as severity, laterality, specific location, chronicity, causation, and treatment encounter is crucial to ensure specificity in ICD-10 coding. To be clear, the trends in national coder discussions contradict the original descriptions and intent of laparoscopic colectomy procedures. Clinical Documentation and Prior Authorization Required Tufts healh plan required authorization for below services. Hired for her dental expertise, Amber brings a wealth of knowledge and understanding of the dental revenue cycle management (RCM) services to MOS. These codes which correspond to similar open procedures that follow in the CPT manual are arranged sequentially (i.e., 47563 includes 47562 plus cholangiography, and 47564 includes 47563 plus exploration of common duct). Colectomy codes are identified as either open or laparoscopic. To begin the operation, the patient is placed in the supine position on the operating table and anesthetized. Resection For example, the ICD-10-PCS open endoscopic approach is defined as cutting through the skin or mucous membrane and any other body layers necessary to expose a body part, and introduction of instrumentation to reach and visualize the site of the procedure. A second example is the open with percutaneous endoscopic assistance approach defined as cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure, and entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to aid in the performance of the procedure.. Surg Endosc. If you continue to use this site we will assume that you are happy with it. However, the key diagnostic method used today is imaging. Z53.31 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. And, you can focus on whats most important patient care. . Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first-choice of treatment for gallstones and inflammation of the gallbladder unless there are contraindications to the laparoscopic approach. Surgeons should be aware that an unlisted procedure requires documentation that provides relevant information, including a proper definition/description of the nature, extent, and need for the procedure, and the time, effort, and equipment necessary to provide the service. We use cookies to ensure that we give you the best experience on our website. The liver, pancreas, and gallbladder are the solid organs of the digestive system. You may appropriately bill the extra time using modifier -22. Appendectomy or laparoscopic appendectomy CPT code (s): 44950, 44955, 44960, 44970 Cholecystectomy or laparoscopic cholecystectomy. Clinical example: A 27-year-old male patient has had Crohns disease (CD) of the terminal ileum for six years. The inclusion of a code does not imply any right to reimbursement or guarantee claim payment. A few small cuts are required for this procedure. 47562 Laparoscopy, surgical; cholecystectomy47563 Laparoscopy, surgical; cholecystectomy with cholangiography47564 Laparoscopy, surgical; cholecystectomy with exploration of common duct. Converting to gain better access or to facilitate removal of the gallbladder is commonplace and, therefore, modifier -22 shouldnt be used. Laparoscopic subtotal cholecystectomy . This is reflected in the relative value units assigned to each procedure: 47562, 18.17; 47563 19.59; 47564, 23.59. Use the table table to answer this item. Clipboard, Search History, and several other advanced features are temporarily unavailable. We will response ASAP. After insufflation with CO2(carbon dioxide), insert the laparoscope and perform a visual inspection of the abdominal contents. Can a laparoscopy be converted to a cholecystectomy? Learn more about correct coding at an ACS General Surgery Coding Workshop. . Coders must also be aware of several coding guidelines and bundling edits that may apply. In order to obtain prior authorization for procedure(s), choose appropriate InterQual SmartSheet(s) listed below. 2022 Dec;36(12):9321-9328. doi: 10.1007/s00464-022-09206-w. Epub 2022 Apr 12. Index: In the Alphabetic Index, under Cholecystectomy, there are two choices: see Excision, Gallbladder (0FB4) and see Resection, Gallbladder (0FT4). A lap chole involves removal of the gallbladder using a laparoscope, and may be performed with or without cholangiography. I code from the record, never by what doctors write at the beginning. In some cases, however, surgeons can bill for significant extra work and time by appending modifier -22 to the appropriate procedure code. Designed by Elegant Themes | Powered by WordPress. In the case of a lap chole converted to an open procedure, an additional diagnosis code V64.4 (laparoscopic surgical procedure converted to open procedure) should be included to indicate that the switch occurred, according to the ICD-9-CM Coding Handbook. 1 What is the CPT for laparoscopic cholecystectomy? Any member who underwent an appendectomy or cholecystectomy (laparoscopic or other) during the 365 day period ending 30 days prior to the end of the measurement year. This study aims to evaluate the reasons for conversion of this operation in the current era of laparoscopic surgery. These codes which correspond to similar open procedures that follow in the CPT manual are arranged sequentially (i.e., 47563 includes 47562 plus cholangiography, and 47564 includes 47563 plus exploration of common duct). These guidelines should be used as a companion document to the official version of the ICD-10-PCS as published on the CMS website. A diagnosis of acute cholecystitis (58.8%) was more common among converted cases. They may inadvertently add things they didnt do or leave out things they did. Because a hole was inadvertently left in the bowel, the procedure becomes more complicated and takes longer to complete. A laparoscopic cholecystectomy may be converted to an open cholecystectomy. Ann Med Surg (Lond). The surgeon, increasingly concerned about proceeding under laparoscopic guidance only, converts to an open approach. Laparoscopic Cholecystectomy is the procedure of gall bladder removal. The design of the study allows wide inclusion criteria for participants . The mortality rate for these patients was 0.7%. This approach involves a picture or minor incision through the skin or mucous membrane and any other body layers necessary using instrumentation to reach the site for the procedure. Find the trace of the plane in the given coordinate plane. The willingness and ability of surgeons to convert to open cholecystectomy continues to be important to the safety of this operation. First, an incision made either by extending a trocar site, at an alternative location (for example, midline), or for HAL does not constitute an open procedure. Discontinued procedures . In addition, CPT code 47562, which had previously been reviewed in 1995 and 2005, was used as a stable reference service when valuing CPT code 47563. Reasons for conversion from laparoscopic to open cholecystectomy: a 10-year review. 2020 Oct 18;17(20):7571. doi: 10.3390/ijerph17207571. 2006). Before Download the app via the Apple Store, Google Play, or Amazon. CPT code 47605 cholecystectomy w/ cholangiography ICD-9 procedure code 51.22 cholecystectomy , 87.53 Intraoperative cholangiogram and will have to add V64.41 laparoscopic surgical procedure converted to open along with your other ICD-9 dx's. B bill2doc Expert Messages 454 Best answers 0 Nov 29, 2012 #3 Thank you very much! Despite its low incidence, the medical implications for the patient can be serious. Biliary lithiasis is a global disorder affecting nearly 20% of the world's population, although most cases occur without symptoms. 2006). For example: Z53.31 Laparoscopic procedure converted to open Z53.32 Thoracoscopic procedure converted to open Z53.33 Arthroscopic procedure converted to open Z53.39 Other specific procedure converted to open It helps people when gallstones cause inflammation, pain or infection. CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). Today, gallbladder removal is done laparoscopically without requiring a large abdominal incision. Price: $6,836. alcoholic drinks, including beer, wine, and spirits. In one cross-sectional study, the conversion from laparoscopic to open surgery for cholecystectomy was only 0.6% (Yuda Handaya et al., 2021). The revenue codes and UB-04 codes are the IP of the American Hospital Association. It can be done either open (the way we've done it for over a hundred years with a long incision und . The surgeon watches the monitor and performs the operation by manipulating the surgical instruments through the operating ports. In this situation, appending modifier -22 to the open cholecystectomy code may be appropriate because the patients condition required more time and effort. The ACS, ASCRS, and SAGES agree that the procedures described as open in the CPT code set have always clearly meant that a laparotomy was performed and that the procedures described as laparoscopic have always clearly meant that the beginning, end, and most or all of the work in . 21 (-2x - 10) > 3 (4 - 6x) Verified answer. Federal government websites often end in .gov or .mil. Laparoscopic cholecystectomy is the procedure of gall bladder removal. My doctor started a laparoscopic cholecystectomy that had . The difference between CPT codes 47562 and 47563 is the work of the intraoperative cholangiography. Note: While you may not be the provider responsible for obtaining prior authorization, as a condition of payment you will need to make sure that prior authorization has been obtained.Tufts Health Plan requires the use of an InterQual SmartSheet to obtain prior authorization for Cholecystectomies. Code the laparoscopic code, 47563, Laparoscopy, surgical . Cholecystectomy is the surgical removal of the gallbladder. When a cholangiogram is performed in conjunction with a lap chole and no radiologist is present, the surgeon will interpret the images on the fluoroscope to guide the procedure. Test us for free with a no obligation trial, get the pricing, and then decide if we are a good fit. It is the preferred procedure for stones removal and inflammation in gall bladder. Laparoscopic cholecystectomy is minimally invasive surgery to remove the gallbladder. Because cholangiography is routinely performed in conjunction with a lap chole, some surgeons forget to mention cholangiography at the top of the operative report, says Elaine Elliott, CPC, an independent general surgery coding specialist in Stuart, Fla. How would I code these two procedures? Listing of a code in this guideline does not imply that the service described by the code is a covered or non-covered health service. Post-cholecystectomy syndrome (PCS) is the term used to describe the persistence of biliary colic or right upper quadrant abdominal pain with a variety of gastrointestinal symptoms, which are similar to the features experienced by an individual before cholecystectomy. Insurance Denial Claim Appeal Guidelines. It is a common treatment of symptomatic gallstones and other gallbladder conditions. Percutaneous endoscopic approach The fifth of the ICD-10-PCS code is for the approach which identifies the method used to reach the operative site. 622 0 obj <>stream Please enable it to take advantage of the complete set of features! 2022 Oct-Dec;12(4):56-63. doi: 10.4103/jwas.jwas_162_22. What is the CPT code for a cholangiogram? The following clinical example and procedural description was used in the development of the code descriptor and the Medicare physician fee schedule work relative value units for code 44205, Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum and ileocolostomy. You now have the opportunity to claim CME credit for time spent reading the monthly Bulletin of the American College of Surgeons. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy. Laparoscopic Cholecystectomy Converted to Open: Create an . Coders have referenced each of these ICD-10-PCS approaches to claim that laparoscopic abdominal procedures that include a minor incision for hand-assistance laparoscopy (HAL) or for extraction or exteriorization of the bowel should be coded as an open procedure. Dont forget to add the appropriate diagnostic code to indicate the conversion. ** Cholecystectomy, Laparoscopic, Cholangiogram Intraoperative with Laparoscopic Cholecystectomy, ** Cholecystectomy, Open, Cholangiogram Intraoperative with Open Cholecystectomy. The surgery involves a few small incisions, and most people go home the same day and soon return to normal activities. Procedure: Laparoscopic cholecystectomy Procedure: Small-incision open cholecystectomy: Phase 2 Phase 3: Detailed Description: . Tip 3: Bill S&I If a Radiologist Isnt Present A scalpel is used to make a small incision at the umbilicus. Answer: You will code an outpatient consultation with a 57 modifier for the evaluation and management (E & M) service. For the "ICD-10 Coding--Bonnie Altus" playlist, go to:https://www.youtube.com/playlist?list=PLRfHZ9wXKs6dJTxMF8y08sxGupC5AAj_PBonnie Altus (MS,RHIA,CHPS) is . 2011-2023 Surgery Center of Oklahoma All rights reserved. Following trends in national coding blogs and websites, institutional coders have concluded that extracorporeal extraction and creation of an anastomosis is an open procedure, making the operation an open colectomy. How painful is laparoscopic gallbladder surgery? Z codes represent reasons for encounters. At the very least, if the surgeons practice is audited, the payer may request a refund. (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury. The ACS also provides clarification on coding in such circumstances in its June 1, 2018 bulletin. This is performed after laparoscopic cholecystectomy (gall bladder removal) for evaluation of bile excretion in small intestine. This work is followed by either an extension of a trocar site incision or creation of a separate small incision for extraction of the specimen and/or extracorporeal creation of an anastomosis based on surgeon preference. Don't forget to add the appropriate diagnostic code to indicate the conversion. Laparoscopic cholecystectomy icd 10 procedure code. Verified questions. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy. The perforated bowel is not an error, says Terry Fletcher, BS, CPC, CCS-P, a coding and reimbursement specialist in Laguna Niguel, Calif. Rather, it should be viewed as an unfortunate side effect of lysing adhesions. 47564 with exploration of common duct. Bingener-Casey J, Richards ML, Strodel WE, Schwesinger WH, Sirinek KR. Chicago, IL 60611, Laparoscopic colectomy description of work, www.cms.gov/Medicare/Coding/ICD10/2019-ICD-10-PCS.html. CPT 81479 oninvasive Prenatal Testing for Fetal Aneuploidies, Top 13 denials in RCM and how to prevent the denials, Critical care codes Usage , Time, Documentation, Medical necessity condition with example, CPT Code 99201, 99202, 99203, 99204, 99205 Which code to USE. Discontinued or incomplete procedures B3.3 If the intended procedure is discontinued or otherwise not completed, code the procedure to the root operation performed. An initial approach to a procedure may be followed at the same encounter by a second, usually more invasive approach. All 5884 patients undergoing laparoscopic cholecystectomy between March 1991 and June 2001 were prospectively collected in a database. However, only one code applies to laparoscopic appendectomy (44970), and it is used to report a laparoscopic appendectomy for either scenario; with rupture or without rupture. Note: Although some carriers may be paying these claims with modifier -53 appended, such billing is nonetheless incorrect. This is the American ICD-10-CM version of, Z codes represent reasons for encounters. Appendectomy or laparoscopic appendectomy CPT code(s): 44950, 44955, 44960, 44970 Cholecystectomy or laparoscopic cholecystectomy, Cholecystectomy or laparoscopic cholecystectomy CPT code(s): 47562, 47563, 47564, 47600, 47605, 47610, 47612, 47620. The following list(s) of codes is provided for reference purposes only and may not be all inclusive. Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do, CPT CODE 47562, 47563, 47564 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY. Patients undergoing uncomplicated laparoscopic cholecystectomy for symptomatic cholelithiasis may be discharged home on the day of surgery (Tenconi, et al. Description of procedure: Place trocars through the abdominal wall at the umbilicus, right lower quadrant, and lower midline. It should feel a bit better each day. The following example is given to illustrate this: If the a surgeon performs an open abdominal procedure and finds that the gallbladder is thickened and inflamed and must be removed, the operative note should include the finding of acute cholecystitis (K81.0) and a description of the cholecystectomy performed. . Second, the method used to perform most of the procedurevia laparoscopy or via a laparotomyestablishes the appropriate code to report. Safe laparoscopic subtotal cholecystectomy in the face of severe inflammation in the cystohepatic triangle: a retrospective review and proposed management strategy for the difficult gallbladder. Select Laparoscopic Cholecystectomy Procedures with and without Common Bile Duct Exploration (CBDE) . Although laparoscopic cholecystectomy is nowadays one of the most performed surgical operation in abdominal surgery, some aspects, concerning the emergency setting, have to be yet investigated. Besides, BDI can also generate significant legal issues in healthcare. Disclaimer. Hand off the resected specimen from the surgical field. What should I not eat with no gallbladder? Tip 1: Read the Entire Operative Report It is a common treatment of symptomatic gallstones and other gallbladder conditions. 5 Can a laparoscopy be converted to a cholecystectomy? Extraction of a specimen and/or creation of anastomosis does not constitute the majority of the procedure. Unfortunately, no. References Atiq-ur-Rehman, S., Hussain, S., Khan, M. Y., & Masood, U. In January 2012, the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) agreed that the physician work had not changed since the October 2010 review and recommended reaffirmation of the RUCs original recommendation for correctly ranked work RVUs (11.87 for 47562 and 12.11 for 47563). Unable to load your collection due to an error, Unable to load your delegates due to an error. All rights reserved. Laparoscopic cholecystectomy is the gold standard treatment for benign gallbladder pathologies. Once the mobilization is complete, remove the trocar in the right lower quadrant and enlarge the incision to allow for delivery of the involved terminal ileum and cecum out of the abdominal cavity. The same policy also states that the interpretation that ultimately guides the further treatment of the patient (i.e., the surgeons) should be paid, although this can be a delicate issue between surgeons and radiologists. In addition, CPT codes 47562 and 47563 describe more complex surgical procedures that have a 090-day global period compared with 47560 which has a 000-day global period. Outsource Strategies International is one of the leading medical billing and coding companies in the medical outsourcing space focused on all aspects of revenue cycle management. Close the skin using a running subcuticular absorbable stitch. Total spending includes insurer and enrollee payments for the facility portion of the surgical procedure; the physician portion billed on a separate professional claim is not included. S syllingk Guest Messages Cholecystitis or gallstone disease occurs when gallstones crystallize (cholelithiasis) and block the release of bile from the gallbladder. National Library of Medicine In this case, the National Correct Coding Initiative Policy Manual for Medicare Services Effective January 1, 2016 states that the physician should not report the failed laparoscopic cholecystectomy or a diagnostic laparoscopy. Physicians receive up to 6.5 AMA PRA Category 1 Credits for each day of participation. 2009 Aug;7(4):338-46. doi: 10.1016/j.ijsu.2009.05.005. Such companies have experienced AAPC-certified coders who are knowledgeable about coding and billing guidelines for this specialty and can ensure accurate claims for optimal reimbursement. You should report CPT code 44146 (see Table 1, page 43). In this situation, only 47605 (cholecystecomy; with cholangiography) should be billed. Laboratory tests used to show evidence of gall bladder disease include liver tests, check of bloods amylase or lipase levels, and complete blood count (CBC). Visualize and protect the duodenum and right ureter during this mobilization. Less than 10% of patients will fail this protocol and another 5% may require hospitalization after returning to their homes. If this finding is omitted from the postoperative diagnosis list, the coding staff should code it after finding it in the documentation., Physicians may perform certain other procedures with laparoscopic cholecystectomy procedures. Can both be billed? Categories. Robotic-assistance, hand-assistance, or minor incision for specimen extraction with or without extracorporeal work is still considered a laparoscopic procedure. He has been treated with multiple medications but continues to have exacerbations of his disease that are severe enough to require time off of work on a regular basis. The minor incision does not allow exposure of the abdominal cavity for the laparoscopic diagnostic examination, mobilization of the intestine, vascular ligation, and final irrigation and inspection. 2017, and November 30, 2021. 633 N. Saint Clair St. A corresponding procedure code must accompany a Z code if a procedure is performed. caffeine, which is often in tea, coffee, chocolate, and energy drinks. Common uncontrolable risk factors for gallstone disorders include being female, being 60 years or older, being of Native American or Mexican-American descent, and family history. In the Unites States, 90% are performed laparoscopically. What is the CPT code for cholecystectomy? and surgeons in the laparoscopic group will aim for laparoscopic cholecystectomy with conversion to open cholecystectomy if this is indicated. CPT Code: 47562, 47563. ICD-10-PCS 0FT40ZZ is a specific/billable code that can be used to indicate a procedure. Let's ra, With the large amounts of clinical documentation a, Arterial embolization is a minimally-invasive proc, Need professional support to meet those medical bi, February is observed as American Heart Month, Streamline the billing process and prevent claim d, Cracking the Code: Understanding CDT Codes for Dental Bridges, Dental Billing Codes for Reporting Osseous Surgery, K80.00 (calculus of gallbladder with acute cholecystitis without obstruction, K80.01 (calculus of gallbladder with acute cholecystitis with obstruction, K80.10 (calculus of gallbladder with chronic cholecystitis without obstruction), K80.11 (calculus of gallbladder with chronic cholecystitis with obstruction), K80.12 (calculus of gallbladder with acute and chronic cholecystitis without obstruction), K80.13 (calculus of gallbladder with acute and chronic cholecystitis with obstruction), K80.18 (calculus of gallbladder with other cholecystitis without obstruction), K80.19 (calculus of gallbladder with other cholecystitis with obstruction), K80.20 (calculus of gallbladder without cholecystitis without obstruction), K80.21 (calculus of gallbladder without cholecystitis with obstruction), K80.30 (calculus of bile duct with cholangitis, unspecified, without obstruction, K80.31 (calculus of bile duct with cholangitis, unspecified, with obstruction), K80.32 (calculus of bile duct with cholangitis, without obstruction), K80.33 (calculus of bile duct with cholangitis, with obstruction), K80.34 (calculus of bile duct with chronic cholangitis, without obstruction), K80.35 (calculus of bile duct with chronic cholangitis, with obstruction), K80.36 (calculus of bile duct with acute and chronic cholangitis, without obstruction), K80.37 (calculus of bile duct with acute and chronic cholangitis, with obstruction), K80.40 (calculus of bile duct with cholecystitis, unspsecified without obstruction), K80.41 (calculus of bile duct with cholecystitis, unspecified, with obstruction), K80.42 (calculus of bile duct with acute cholecystitis without obstruction), K80.43 (calculus of bile duct with acute cholecystitis with obstruction), K80.44 (calculus of bile duct with chronic cholecystitis without obstruction), K80.45 (calculus of bile duct with chronic cholecystitis with obstruction), K80.46 (calculus of bile duct with acute and chronic cholecystitis without obstruction), K80.47 (calculus of bile duct with acute and chronic cholecystitis with obstruction), K80.50 (calculus of bile duct without cholangitis or cholecystitis without obstruction), K80.51 (calculus of bile duct without cholangitis or cholecystitis with obstruction), K80.60 (calculus of gallbladder and bile duct with cholecystitis, unspecified, without obstruction), K80.61 (calculus of gallbladder and bile duct with cholecystitis, unspecified, with obstruction), K80.62 (calculus of gallbladder and bile duct with acute cholecystitis without obstruction), K80.63 (calculus of gallbladder and bile duct with acute cholecystitis with obstruction), K80.64 (calculus of gallbladder and bile duct with chronic cholecystitis without obstruction), K80.65 (calculus of gallbladder and bile duct with chronic cholecystitis with obstruction), K80.66 (calculus of gallbladder and bile duct with acute and chronic cholecystitis without obstruction), K80.67 (calculus of gallbladder and bile duct with acute and chronic cholecystitis with obstruction), K80.7 (calculus of gallbladder and bile duct without cholecystitis), K80.70 (calculus of gallbladder and bile duct without cholecystitis without obstruction), K80.71 (calculus of gallbladder and bile duct without cholecystitis with obstruction), K80.80 (other cholelithiasis without obstruction), K80.81 other cholelithiasis with obstruction), K81.2 (acute cholecystitis with chronic cholecystitis), 47562 (laparoscopic cholecystectomy without cholangiography), 47563 (laparoscopic cholecystectomy with cholangiography), 47564 (laparoscopic cholecystectomy with exploration of the common bile duct), 47600 (cholecystectomy without cholangiography), 47605 (cholecystectomy with cholangiography), 47610 (cholecystectomy with exploration of the common bile duct), 47612 (cholecystectomy with exploration of common bile duct; with choledochoenterostomy), 47620 (cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography).