Find information on biliary stent removal, also known as biliary stent extraction or biliary stent retrieval. This resource covers clinical documentation and medical coding for biliary stent procedures, including healthcare guidelines and best practices for accurate and efficient coding and billing. Learn about the indications, contraindications, and complications associated with biliary stent removal and how to properly document these procedures in medical records.
Also known as
Removal of biliary drainage device
Removal of biliary stents or drainage catheters.
Complications of other specified internal prosthetic devices
Complications related to biliary stents (removal-related issues can be included here).
Mech compl of other internal prosth dev, init encntr
Mechanical complication of biliary stent during initial encounter, which could involve removal.
Follow this step-by-step guide to choose the correct ICD-10 code.
Was the biliary stent removal routine?
Yes
Code 0FB28ZZ Removal of biliary drainage device or stent, percutaneous approach
No, complicated by...
Obstruction/blockage?
When to use each related code
| Description |
|---|
| Removal of a biliary stent. |
| Placement of a biliary stent. |
| Revision of a biliary stent. |
Separate coding for stent removal and related procedures (e.g., cholangiography) when a comprehensive code exists, leading to overpayment.
Lack of documentation specifying the removal technique (e.g., endoscopic, percutaneous) may lead to incorrect code assignment and claim denials.
Failure to document and code complications during stent removal (e.g., perforation, bleeding) impacts reimbursement and quality metrics.
Q: What are the best practices for difficult biliary stent removal in patients with altered anatomy or impacted stents?
A: Difficult biliary stent removal cases, especially those involving altered anatomy post-Whipple procedure or impacted/embedded stents, require careful planning and advanced techniques. Pre-procedural imaging, such as MRCP or CT, is crucial for assessing the stent's position, the degree of impaction, and any anatomical variations. Consider implementing intraoperative cholangioscopy for direct visualization and guidance during the removal process. For impacted stents, mechanical lithotripsy, balloon dilatation, or the use of specialized retrieval baskets or forceps can be beneficial. Explore how various endoscopic accessories can aid in navigating challenging anatomy and facilitating successful stent retrieval while minimizing complications. In particularly complex cases, referral to a tertiary center with expertise in advanced endoscopic procedures may be warranted.
Q: How can I minimize complications like bleeding and perforation during endoscopic biliary stent removal?
A: Minimizing complications during biliary stent removal requires a thorough understanding of the patient's anatomy, coagulation status, and the stent's characteristics. Pre-procedural assessment should include a detailed review of prior imaging and laboratory results. During the procedure, gentle manipulation of the endoscope and accessories is essential. Employing techniques like electrocautery with caution can help manage bleeding, while careful advancement of instruments can reduce the risk of perforation. For patients with coagulopathies, consider implementing appropriate corrective measures prior to the procedure. Learn more about advanced endoscopic techniques and best practices for preventing and managing potential complications during biliary stent removal to improve patient outcomes. Regularly reviewing updated guidelines and literature can further enhance your expertise in this area.
Patient presented for endoscopic removal of biliary stent. The patient's medical history includes choledocholithiasis, previously managed with endoscopic retrograde cholangiopancreatography (ERCP) and biliary stent placement. Indications for stent removal included resolution of the obstructing stone and normalization of liver function tests. The procedure was performed under conscious sedation. A duodenoscope was advanced into the duodenum and the biliary stent was visualized. Using endoscopic forceps, the stent was successfully grasped and removed without complication. Post-procedure cholangiogram demonstrated patent biliary ducts with no residual stones or strictures. The patient tolerated the procedure well and was discharged home the same day with instructions for follow-up. Diagnosis: Status post biliary stent placement, now removed. Procedure: Endoscopic biliary stent removal. ICD-10-PCS code: 0FB78ZZ. CPT code: 43264.