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CPT 48145: Distal Pancreatectomy With or Without Splenectomy
CPT code 48145 denotes distal pancreatectomy — removal of the tail and/or body of the pancreas, with optional splenectomy and, when necessary for ductal obstruction, creation of a pancreaticojejunostomy. This code represents a major abdominal surgical procedure with implications for surgical subspecialties, hospital resource use, and post-operative care. Nationally, procedures captured by this code are relevant for policy discussions on surgical outcomes, resource allocation, and bundled payment models for complex pancreatic surgery.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of procedural benchmarks, payer coverage patterns, and clinical context for use of the code. The publication outlines typical sites of service and common clinical scenarios that trigger use of this code, summarizes available reimbursement and coverage considerations, and highlights areas where coding specificity affects claims processing and payment. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 48145 describes surgical removal of the distal portion of the pancreas, performed with or without concurrent removal of the spleen. The procedure also includes, when indicated for pancreatic duct obstruction, creation of an anastomosis connecting the pancreas to the jejunum.
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Service Type: Surgical resection of the pancreas (distal pancreatectomy), with possible splenectomy and pancreaticojejunostomy when needed
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Typical Site of Service: Inpatient hospital or ambulatory surgery center for major abdominal surgery