Cracking the Code

Pancreas Procedures

Pancreas procedures are coded 48000–48999. Most common are the Whipple-type procedures. A Whipple procedure (48150) may also be called a pancreaticoduodenectomy or pancreatoduodenectomy. This procedure is a major surgical operation involving the pancreas, duodenum, and other organs. This procedure is normally performed to treat malignancies in the head of the pancreas, or malignant tumors involving the common bile duct or duodenum near the pancreas. The coding depends on how much of the duodenum is removed (total to near total) and if a pancreatojejunostomy is performed. In the absence of the anastomosis to the jejunum (pancreatojejunostomy), report code 48154.

Internal anastomosis of a pancreatic cyst to the gastrointestinal tract may be performed and reported using code 48520. CPT code 48540 should be used when Roux-en-Y anastomosis to drain enzymes from the pancreatic duct is used. This procedure is characterized by the approach used.

Q: What CPT code is reported for a proximal subtotal pancreatectomy, with total duodenectomy, partial gastrectomy, choledochoenterostomy, and gastrojejunostomy, with pancreatojejunostomy?
A: 48150 Rationale: CPT code 48150 is specifically for pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy, and gastrojejunostomy (Whipple-type procedure); with pancreatojejunostomy. We will look in the CPT Index for Pancreas/Excision/Partial.
Reference: 2024 CPT code book
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