CCSD code J1900 – Anastomosis of gallbladder to another organ

Key takeaways

CCSD code J1900 covers an operation that joins the gallbladder to the stomach, duodenum or jejunum.

Surgeons mostly use it as a bypass when a blockage low in the bile duct stops bile from draining.

If the gallbladder was removed, or a bile duct was joined instead, a neighboring code such as J1800 or J3000 applies.

Fees vary by insurer. Freedom Health Insurance rates J1900 as Xmajor and pays the surgeon £700 on its July 2026 schedule.

The pre-authorization should name J1900 itself, so update it if the plan changed during the operation.

CCSD code J1900 joins the gallbladder to another organ

CCSD code J1900 is the UK private insurance code for “anastomosis of gall bladder (to another viscus).” The surgeon creates a new opening between the gallbladder and a nearby hollow organ. That organ is usually the jejunum, the duodenum or the stomach.

Bile then drains from the liver through the cystic duct and gallbladder, straight into the bowel. The blocked lower part of the common bile duct is bypassed rather than removed.

CCSD stands for Clinical Coding & Schedule Development. Its schedule is the procedure code set UK private medical insurers, such as Bupa, use to pay specialists. Our guide to CCSD codes explains how the schedule is organized.

How J1900 lines up with OPCS-4

NHS hospitals record the same operation under OPCS-4 category J19, “Connection of gall bladder.” Its first four codes name the organ the gallbladder is joined to.

OPCS-4 also has separate codes for revising or closing a gallbladder anastomosis, J19.5 and J19.6. Check the CCSD schedule before you bill J1900 for either of those operations.

Why surgeons build a gallbladder bypass

Most J1900 operations are palliative. A tumor in the head of the pancreas or the lower bile duct squeezes the duct shut. Bile backs up, and the patient develops jaundice, itching and a poor appetite.

Joining the gallbladder to the jejunum gives bile a new route out. It suits patients whose tumor cannot be removed but who are fit enough for surgery. An endoscopic stent is the main alternative, so the notes should say why surgery was chosen.

The bypass only works when the cystic duct is open. The blockage also has to sit well below the point where the cystic duct joins the bile duct. Surgeons check both on imaging first, and the operative note should record what they found.

Neighboring codes decide whether J1900 is right

J1900 sits in the CCSD section for other organs (mainly digestive), next to the gallbladder and bile duct codes. Several of those neighbors describe operations that look alike on a surgical list.

One question about the operative note sorts them: what happened to the gallbladder?

A removed gallbladder cannot also be joined to the bowel. For that reason, J1900 never belongs on the same claim as a cholecystectomy code for one operation. When in doubt, check the unacceptable combinations listed against J1900 on the CCSD schedule.

Descriptors in the table follow the Freedom Health Insurance chapter 11 schedule. For how one large insurer applies CCSD codes, see our Bupa CCSD codes guide.

The diagnosis code has to explain the blockage

Insurers read the ICD-10 code to see why the bypass was needed. A gallstone diagnosis on its own may prompt a query, because gallstones are usually treated by removing the gallbladder.

Check each code in the WHO ICD-10 browser against the operative note. Code the confirmed diagnosis, not the working one from the referral letter.

A J1900 operative note has to show what was joined

The insurer pays for the operation the note describes. A vague note forces the claims team to guess, and a guessed code invites a query. Make sure the note records these points.

• The organ joined to the gallbladder, whether stomach, duodenum or jejunum.
• The approach, open or laparoscopic.
• The cause and level of the blockage, with the imaging that confirmed it.
• Whether the cystic duct was open at the time of surgery.
• Any extra procedure, such as a gastrojejunostomy, which carries its own code.

That last point comes up often in palliative surgery. A pancreatic head tumor can block the duodenum as well as the bile duct, so the surgeon may add a gastrojejunostomy. The second join is billed under G3210, so check the insurer accepts the pair.

Consent belongs on the same record. Insurers can ask for the signed form, and a missing one slows payment. Practices using digital consent forms collect the signature before surgery and file it with the patient record.

How a J1900 claim moves from referral to payment

A J1900 claim passes through five hands before it is paid. Each step adds a detail the next one relies on.

1. Pre-authorization. The patient or practice asks the insurer to approve J1900 before surgery. Record the authorization number.
2. Surgery and note. The surgeon documents the anastomosis, the organ joined and the reason for the bypass.
3. Coding. The coder matches the note to J1900 and the ICD-10 code for the blockage.
4. Submission. The claim goes to the insurer, often electronically through Healthcode.
5. Payment or query. The insurer pays against its own fee schedule or sends a query. Answer it from the operative note.

Each insurer sets its own fee for J1900. On its July 2026 schedule, Freedom Health Insurance rates J1900 as Xmajor. It pays £700 to the surgeon and £357 to the anesthetist. Other insurers publish their own figures, so quote from the patient’s policy.

What trips up a J1900 claim

Most rejected J1900 claims fail for one of five reasons. Each has a simple fix if you catch it before submission.

Run these checks before a J1900 claim goes out

A two-minute review catches most of the problems above. Work through this list before you press send.

• The gallbladder was left in place and joined to another organ.
• No cholecystectomy code sits on the same claim.
• The ICD-10 code names the blockage or tumor in the operative note.
• The authorization number covers J1900, not a different code.
• The fee matches the patient’s insurer schedule.
• The signed consent form and imaging report are on file.

How Pabau keeps J1900 claims tied to the operative record

In many surgical practices, the operative note lives in one system and the authorization number in an inbox. Someone then retypes the claim, and each re-keyed field can introduce an error.

Pabau keeps those details on one patient record instead. The insurer and policy sit on the record, and the CCSD and ICD-10 codes link on the invoice. With claims management, the claim goes to Healthcode without leaving Pabau.

Before a claim is sent, Pabau checks that required fields, such as membership and authorization numbers, are filled in. It does not pick the code for you, so the checks above still matter. Teams outside the UK send claims the same way, through Claim.MD in the US or Tyro Health in Australia.

Send J1900 claims from one patient record

Pabau helps UK private surgical teams keep operative notes, CCSD codes and Healthcode claims on one record, so fewer details get retyped.

Book a demo

Conclusion

J1900 is simple to bill once the note confirms two facts. The gallbladder stayed in place, and the surgeon joined it to another organ.

Most errors come from a neighboring code, a gallstone-only diagnosis or an authorization for a different operation. Catch those before submission, and the insurer has little reason to query the claim.

Book a demo to see how Pabau links the operative record, the CCSD code and the Healthcode claim for your billing team.

Continue your research

Coding a gallbladder removal instead? CCSD code J1820 covers cholecystectomy with bile duct exploration.

Billing another digestive anastomosis? CCSD code J5900 explains anastomosis of the pancreatic duct.

Adding a gastrojejunostomy to the same operation? CCSD code G3210 covers gastrojejunostomy claims.

Checking what Bupa pays? Bupa procedure codes and fee schedule links Bupa codes to their fees.

Frequently asked questions