Summary & Overview
CPT 47490: Percutaneous Gallbladder Drainage and Catheter Placement
CPT code 47490 denotes a percutaneous, minimally invasive procedure to create an opening in the gallbladder and place a drainage catheter. This intervention is commonly used for decompression or drainage of an acutely inflamed or obstructed gallbladder when endoscopic or surgical approaches are contraindicated or deferred. Nationally, the code matters because it represents a critical interventional radiology service that can reduce morbidity in high-risk surgical patients and inform reimbursement and access for acute biliary care.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find national benchmarks on utilization and payment patterns, a concise clinical context for appropriate use, and recent policy updates affecting coverage and site-of-service considerations. The publication outlines coding nuances tied to procedural reporting, common service settings such as hospital outpatient departments and interventional radiology suites, and implications for billing workflows. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 47490 describes a minimally invasive percutaneous procedure to create an opening in the gallbladder and place a catheter. The service involves image-guided access to the gallbladder through the skin, creation of a drainage tract, and insertion of a catheter to allow external drainage of bile or decompression of an inflamed or obstructed gallbladder.
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Service type: Interventional percutaneous gallbladder drainage
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Typical site of service: Hospital outpatient department or interventional radiology suite (percutaneous, image-guided procedure)
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Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult with acute cholecystitis who is a high surgical risk due to comorbid cardiopulmonary disease or advanced age. The patient presents with right upper quadrant pain, fever, leukocytosis, and ultrasound evidence of gallbladder wall thickening or pericholecystic fluid. Interventional radiology is consulted for a minimally invasive drainage option. Under conscious sedation or monitored anesthesia care in an outpatient interventional radiology suite or inpatient radiology procedure room, the interventional radiologist obtains image guidance (ultrasound and/or fluoroscopy) to access the gallbladder percutaneously, aspirate infected bile if present, create a controlled tract, and place a drainage catheter. Postprocedure, catheter function is confirmed, samples may be sent for culture, hemodynamic status is monitored, and the patient is admitted or discharged with catheter care instructions and follow-up arranged for catheter management or interval cholecystectomy if appropriate. Emergency use of this procedure occurs for sepsis from acute cholecystitis in unstable surgical candidates; elective use occurs for symptomatic gallbladder drainage in chronic cholecystitis or malignancy-associated obstruction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier reported | Rarely used; placeholder when no specific modifier applies. |