AHA Coding Clinic® for HCPCS - 2022 Issue 1; Ask the Editor

Laparoscopic cholecystectomy with fluorescence imaging

A patient presented for a robotic assisted laparoscopic cholecystectomy with intraoperative fluorescence imaging using indocyanine green (ICG) dye. Once ports were placed and the robot was docked, the gallbladder was retracted and the cystic duct, cystic artery and infundibulum of the gallbladder were identified. ICG, administered intravenously, was used to visualize the common bile and cystic duct insertions which were identified and clipped. The gallbladder was then dissected off the gallbladder fossa. Is the use of fluorescent imaging with injection of ICG during a laparoscopic cholecystectomy considered intraoperative cholangiogram and reported with CPT code 47563, Laparoscopy, surgical; cholecystectomy with cholangiography? If so, can HCPCS Level II code C9776, Intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (e.g., cystic duct, common bile duct and common hepatic duct) with intravenous administration of indocyanine green (ICG) (list separately in addition to code for primary procedure), be additionally reported with reported with CPT code 47563? ...

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