Overview of CPT Code 25076: Endoscopic Retrograde Cholangiopancreatography (ERCP) with Balloon Sweeping
Endoscopic Retrograde Cholangiopancreatography (ERCP) with Balloon Sweeping is a minimally invasive procedure used to diagnose and treat conditions affecting the bile ducts and pancreatic duct. It combines endoscopy and fluoroscopy to visualize and manipulate these ducts, often involving balloon sweeping to clear obstructions.
When CPT Code 25076 is Used?
This procedure is indicated in various clinical scenarios.
- Suspected bile duct obstruction due to gallstones.
- Cholangiocarcinoma or other tumors affecting the bile ducts.
- Pancreatitis with suspected complications.
- Strictures in the bile or pancreatic ducts.
- Post-operative complications involving the biliary system.
Symptoms Indicating This Procedure
Patients may present with several symptoms that warrant this procedure.
- Jaundice (yellowing of the skin and eyes).
- Abdominal pain, particularly in the upper right quadrant.
- Nausea and vomiting.
- Dark urine and pale stools.
- Fever and chills, indicating possible infection.
Causes and Risk Factors
Several factors can contribute to the need for ERCP with balloon sweeping.
- Gallstones blocking the bile duct.
- Chronic pancreatitis.
- Biliary strictures from previous surgeries.
- Tumors in the pancreas or bile ducts.
- Infections such as cholangitis.
Diagnostic Tests Before Procedure
Prior to the procedure, several diagnostic tests may be performed.
- Ultrasound of the abdomen to visualize the biliary system.
- CT scan to assess for masses or obstructions.
- MRI with MRCP to obtain detailed images of the bile ducts.
- Blood tests to check liver function and signs of infection.
Procedure Description
The ERCP procedure involves several key steps.
- The patient is positioned comfortably and sedated.
- An endoscope is inserted through the mouth and guided to the duodenum.
- Contrast dye is injected into the bile and pancreatic ducts.
- Fluoroscopy is used to visualize the ducts and identify obstructions.
- A balloon is inserted and inflated to sweep away blockages.
- Stents may be placed if necessary to keep ducts open.
Preparation for the Procedure
Patients should follow specific guidelines before the procedure.
- Avoid eating or drinking for at least 6-8 hours prior.
- Inform the doctor of any medications being taken.
- Discuss any allergies, especially to contrast dye.
- Arrange for someone to drive home post-procedure.
Recovery and Aftercare
Post-procedure recovery is generally straightforward.
- Patients may experience mild discomfort or bloating.
- Rest for the remainder of the day is recommended.
- Follow a light diet for the first 24 hours.
- Monitor for any signs of complications, such as fever or severe pain.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Pancreatitis following the procedure.
- Infection of the bile ducts.
- Bleeding at the site of intervention.
- Perforation of the duodenum or bile ducts.
- Allergic reactions to contrast dye.
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Post-Procedure Follow-Up
Follow-up care is essential for monitoring recovery.
- A follow-up appointment is typically scheduled within a week.
- Patients should report any unusual symptoms immediately.
- Blood tests may be repeated to assess liver function.
Alternative Treatments
There are non-surgical options available for managing similar conditions.
- Medication to manage pain and inflammation.
- Endoscopic sphincterotomy for stone removal.
- Percutaneous drainage for abscesses or fluid collections.
- Lifestyle changes to manage gallstone formation.
Home Care Tips
Patients can take steps to aid recovery at home.
- Stay hydrated and rest adequately.
- Avoid heavy meals and alcohol for a few days.
- Take prescribed medications as directed.
- Keep the follow-up appointment and monitor symptoms.
Patient Education & Prevention
Understanding risk factors can help prevent recurrence.
- Maintain a healthy diet low in saturated fats.
- Stay active to reduce the risk of gallstones.
- Regular check-ups if at risk for biliary diseases.
- Seek prompt medical attention for symptoms of biliary obstruction.
Billing and Coding Information
CPT Code: 25076
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- LT - Left side
- RT - Right side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $1,500 to $5,000.
- Most insurance plans cover ERCP when medically necessary.
- Out-of-pocket costs depend on the insurance policy.
Related CPT Codes
- 10000 - Incision and drainage of a cyst
Frequently Asked Questions (FAQs)
What is ERCP?
ERCP is a procedure used to diagnose and treat conditions of the bile and pancreatic ducts.
Is ERCP painful?
Patients may experience some discomfort, but sedation is used to minimize pain.
How long does the procedure take?
The procedure typically takes about 30 minutes to an hour.
What should I expect after ERCP?
Mild bloating and discomfort are common, but serious complications are rare.
Can I eat after the procedure?
You may be advised to start with clear liquids and gradually return to a normal diet.
