CPT 47361 Hepatic Hemorrhage Reimbursement | OpenPayer

Summary & Overview

CPT 47361: Operative Control of Liver Hemorrhage, Debridement and Closure

CPT code 47361 denotes operative control of liver hemorrhage, involving debridement, promotion of clotting, and closure with sutures or staples. This code captures an urgent surgical intervention used to manage active hepatic bleeding from trauma, surgical complications, or spontaneous hemorrhage. Nationally, accurate use of CPT code 47361 matters for clinical documentation, hospital case mix reporting, and appropriate surgical claims adjudication.

Key payers commonly involved in coverage and review of this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find operational context for coding this procedure, typical sites of service, and the clinical circumstances that prompt its use. The publication provides benchmarks and policy-relevant guidance on documentation expectations, common billing modifiers (listed separately), and connections to related surgical and diagnostic services.

The analysis offers a concise clinical context for procedural coding, highlights payer coverage scope, and outlines what providers and billing teams should confirm in the medical record to support use of CPT code 47361. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 47361hepatic hemorrhageliver surgerysurgical hemostasisoperative procedurehospital inpatientprocedure codingsurgical billing

Billing Code Overview

CPT code 47361 describes a surgical procedure to control hemorrhage of the liver. The procedure includes debridement of the affected hepatic site, measures to encourage clotting, and closure of the bleeding site with sutures or staples.

Service type: Surgical hemostasis of the liver (operative management of hepatic hemorrhage)
Typical site of service: Hospital operating room or other inpatient surgical setting where operative control of hepatic bleeding is performed

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who presents emergently to the hospital after blunt or penetrating abdominal trauma with ongoing intraperitoneal bleeding and hemodynamic instability. Trauma evaluation (primary and secondary survey) and focused assessment with sonography for trauma (FAST) reveal free intraperitoneal fluid and suspected hepatic laceration. The patient is taken to the operating room for exploratory laparotomy. Intraoperatively the surgeon identifies active hemorrhage from a liver laceration. The operative team performs selective control of hepatic bleeding by debriding devitalized tissue, achieving hemostasis with sutures, staples, topical hemostatic agents, and direct pressure, and closes the liver capsule or parenchymal defect.

Perioperative workflow includes anesthetic induction, blood product availability and transfusion management, intraoperative hemodynamic monitoring, documentation of estimated blood loss and hemostatic maneuvers, and postoperative ICU or surgical floor monitoring for recurrent bleeding, bile leak, or infection. The procedure is coded to reflect direct control of liver hemorrhage through debridement and closure of the bleeding site.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or technical difficulty substantially exceeds the usual service for control of liver hemorrhage.

CPT 47350: Simple Repair of Hepatic Hemorrhage

CPT-47362-LIVER-HEMORRHAGE-REVISION-EXPLORATION

CPT 47362: Re-entry for Liver Hemorrhage, Clot and Packing Removal

CPT-47360-COMPLEX-HEPATIC-HEMORRHAGE-REPAIR

CPT 47360: Complex Repair of Hepatic Hemorrhage

CPT-47300-OPEN-SURGICAL-DRAINAGE-LIVER-ABSCESS-CYST

CPT 47300: Open Surgical Drainage of Liver Cyst or Abscess

Taxonomy Code	Specialty	Notes
207P00000X	General Surgery	Most common specialty performing operative control of liver hemorrhage.
2080P0006X	Trauma Surgery	Common for emergent operative management in traumatic liver injuries.
208600000X	Surgical Critical Care	Often involved for perioperative and ICU management of these patients.
208800000X	Acute Care Surgery	Proceduralists who manage emergent abdominal surgical conditions including hepatic bleeding.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S36.111A`	Laceration of liver, initial encounter	Direct traumatic liver laceration causing hemorrhage treated by operative control.
`S36.119A`	Unspecified injury of liver, initial encounter	Used when liver injury is documented but not otherwise specified, leading to operative hemostasis.
`S36.191A`	Other injury of liver, initial encounter	Captures other specified hepatic injuries requiring surgical control of bleeding.
`I85.00`	Esophageal varices with bleeding, without mention of bleeding	Variceal bleeding is a hepatic-related hemorrhagic condition that may rarely require operative liver-directed interventions.
`K75.4`	Peliosis hepatis	Rare hepatic vascular condition that can present with spontaneous hepatic hemorrhage and require operative control.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`32551`	Tube thoracostomy, includes connection to drainage system (separate procedure)	May be performed concurrently in trauma patients with thoracic injuries and hemodynamic compromise.
`44120`	Enterolysis (separate procedure)	Could be performed if concomitant bowel injury or contamination requires repair during exploratory laparotomy.
`47562`	Laparoscopic cholecystectomy; with cholangiography	Not directly related but illustrative of other hepatobiliary procedures that may occur in the same operative setting when indicated.
`36415`	Collection of venous blood by venipuncture	Common ancillary service for pre/postoperative labs and type and crossmatch for transfusion.
`99100`	Anesthesia for emergency major abdominal surgery	Anesthesia codes and modifiers apply when emergent general anesthesia is provided for exploratory laparotomy and hepatic control.

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