Summary & Overview
HCPCS C7545: Percutaneous Biliary Drainage Catheter Exchange with Calculi Removal
HCPCS Level II code C7545 denotes a percutaneous exchange of a biliary drainage catheter with removal and/or destruction of calculi or debris from the biliary ducts and/or gallbladder, performed under imaging guidance and including diagnostic cholangiography when done. This interventional radiology procedure is commonly performed for biliary obstruction, infected biliary systems, or to manage retained biliary stones, and its inclusion of imaging and documentation components makes it a comprehensive billing entry for radiology and hospital outpatient services. Nationally, C7545 matters because it captures bundled radiologic and therapeutic elements that affect facility and professional billing for complex biliary interventions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, common modifiers, and payer coverage patterns where available. The publication outlines typical sites of service, the procedural components captured by the code (catheter exchange, stone removal, imaging guidance, and interpretation), and what to expect in terms of billing classification for interventional radiology and hospital outpatient service lines. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code C7545 describes a percutaneous exchange of a biliary drainage catheter with removal and destruction of calculi or debris from the biliary ducts and/or gallbladder. The procedure includes any method of stone destruction (for example, mechanical, electrohydraulic, lithotripsy) when performed, diagnostic cholangiography(s) when performed, imaging guidance such as fluoroscopy, and all associated radiological supervision and interpretation.
Service type: Interventional radiology biliary procedure
Typical site of service: Hospital outpatient department or interventional radiology suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of choledocholithiasis and an indwelling internal-external biliary drainage catheter presents with fever, right upper quadrant pain, and cholestatic liver enzyme elevation. Imaging (ultrasound and CT) demonstrates biliary ductal debris and suspected migration of calculi within the common bile duct. Interventional radiology is consulted for percutaneous management. The typical clinical workflow includes: pre-procedure review of imaging and laboratory tests (coagulation profile), informed consent, conscious sedation or monitored anesthesia care, and transfer to the angiography suite. Under fluoroscopic guidance, the existing internal-external biliary drain is exchanged percutaneously; contrast cholangiography is performed to delineate ductal anatomy and to identify calculi/debris. Mechanical or electrohydraulic lithotripsy is used as needed to fragment large stones, with retrieval of stone fragments and biliary debris via catheter and ancillary devices. Post-procedure cholangiography confirms ductal clearance and catheter position; an external-only drainage catheter may be left in place for decompression. The procedure includes all imaging guidance, diagnostic cholangiography when performed, and radiological supervision and interpretation as described by billing code C7545. Typical monitoring continues in recovery with antibiotics as indicated and follow-up imaging or catheter management as an outpatient.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |