Summary & Overview
CPT 47701: Hepatic Biliary-Enteric Anastomosis for Biliary Atresia
CPT code 47701 represents a specialized surgical biliary reconstruction in which a segment of small intestine is anastomosed to the liver surface to restore bile flow when native bile ducts are absent or obstructed, such as in congenital biliary atresia. This procedure is clinically significant because it can be curative or bridge patients to transplant, and it drives high-acuity inpatient surgical resource use and complex postoperative care. Key national payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for the procedure, typical sites of service, and the role this surgery plays in pediatric hepatobiliary care. The publication also summarizes common billing considerations, standard modifier usage where available, and what is known about payer coverage patterns and reimbursement benchmarks. Finally, the article highlights areas where policy updates or payer-specific rules commonly affect claims adjudication and documentation expectations. Data not available in the input is noted where payer-specific rates, diagnosis coding lists, and taxonomies are required for detailed claim-level guidance.
Billing Code Overview
CPT code 47701 describes a surgical procedure in which a portion of the small intestine is attached to the surface of the liver to create a conduit for bile drainage. This operation is performed as a substitute for blocked or malformed bile ducts, most commonly in cases of congenital biliary atresia.
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Service type: Surgical biliary reconstruction
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Typical site of service: Inpatient hospital operating room with postoperative inpatient care
Clinical & Coding Specifications
Clinical Context
A full-term infant diagnosed with congenital biliary atresia presents at 6 weeks of age with progressive jaundice, pale stools, and rising direct bilirubin. After initial evaluation including abdominal ultrasound and hepatobiliary iminodiacetic acid (HIDA) scan demonstrating absent bile duct excretion, the pediatric hepatology and pediatric surgery teams plan a surgical portoenterostomy (47701, Kasai procedure). The clinical workflow includes preoperative evaluation (labs, coagulation studies, imaging), multidisciplinary consent with family, anesthesia assessment, and perioperative antibiotic prophylaxis. In the operating room under general anesthesia, the surgeon performs exploratory laparotomy, excises obliterated extrahepatic bile ducts, and anastomoses a Roux-en-Y limb of jejunum to the hepatic porta to establish bile drainage. Postoperative care includes neonatal intensive care monitoring, serial liver function testing, fat-soluble vitamin supplementation, and long-term follow-up by pediatric hepatology to assess bile drainage and timing of possible liver transplantation if biliary drainage fails.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |