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The liver, gallbladder, and pancreas play important roles in digestion through the release of bile and digestive enzymes. The ductwork that connects these organs to each other and ultimately to the alimentary canal of the gastrointestinal tract, is often a mysterious part of the human body that is overlooked, so let’s look at how the biliary system works.

The liver is responsible for filtering toxins from the blood and generating bile, which assists in the digestive process. Bile is transported from the liver to the gallbladder for storage and from the gallbladder to the small intestine through a network of ducts. Understanding how bile travels through this network can help you understand how and why certain biliary procedures are performed. In turn, this makes it easier to decipher the CPT codes.

Bile leaves the liver through the right and left hepatic ducts, which join to form the common hepatic duct. The cystic duct extends downward from the liver and joins with the common hepatic duct to create the common bile duct (CBD). The CBD connects to the duodenum at the ampulla of Vater (major duodenal papilla), but not before its junction with the pancreatic duct.

The pancreatic duct carries digestive enzymes formed in the pancreas. Bile mixed with pancreatic enzymes are released into the duodenum (small intestine) to assist in the breakdown of food.

Medical Terminology Tips:

  • The hepatic (Greek for liver) ducts are so named because they drain bile from the liver: the right hepatic duct from the right liver lobe and the left hepatic duct from the left liver lobe. The right and left hepatic ducts connect to form the common hepatic duct.
  • The cystic (Greek for bladder) duct is named after the gallbladder.
  • The common bile duct is the joining together of the common hepatic and cystic ducts.

Patients with liver or pancreatic tumors, or with gallstones are prone to blockages in the biliary tree. Procedures commonly performed on the biliary tract include endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous biliary drainage.  While ERCP is an endoscopic procedure performed in the endoscopy suite, percutaneous biliary drainage is commonly performed in an interventional radiology suite using fluoroscopic guidance.

If you want to learn more about these procedures including how they are performed via various approaches and how to assign CPT codes to them, be sure to check out our webinar titled “Minimally Invasive Liver and Biliary CPT Coding,” which will be released on September 22, 2022.

Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer

Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer

Director of Coding Quality & Education

Kristi is a senior consultant with more than 20 years of industry experience. She develops and delivers training on ICD-10-CM/PCS and CPT, both virtually and in classroom settings.
Kristi also performs DRG and APC audits and is known for her vast knowledge on coding vascular interventional radiology procedures. Kristi has an extensive background in coding education and consulting and is a national speakers on topics related to ICD-10 and CPT coding as well as code-based reimbursement.

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