CPT® Code 0346T | Case2Code

Official Description

Ultrasound, elastography (List separately in addition to code for primary procedure)

Common Language Description

The CPT® Code 0346T refers to a specialized ultrasound procedure known as elastography, which is performed to assess the elastic properties of soft tissue. This imaging technique is particularly valuable in diagnosing various conditions affecting organs such as the liver, breast, thyroid, prostate, as well as muscles and tendons. Elastography utilizes different ultrasound (US) techniques to create both qualitative and quantitative image maps that provide insights into the mechanical properties of the target tissue. One common method, strain elastography, employs real-time two-dimensional visualization to generate an elastographic map by applying low-frequency compression through a handheld ultrasound transducer or by utilizing physiological movements of the body, such as breathing or pulsation. This technique is primarily utilized in musculoskeletal imaging. Another method, acoustic radiation force impulse (ARFI) elastography, involves the internal excitation of tissue via a focused ultrasound pulse, resulting in a qualitative color-coded or grayscale image that reflects tissue stiffness. ARFI is particularly useful for imaging deeper tissues, including the liver, thyroid, and breast. Additionally, shear wave elasticity imaging (SWEI) is employed to produce tissue images based on the sideways travel of ultrasound waves generated by the transducer, making it suitable for deep tissue imaging. A variant of SWEI, known as transient vibration controlled elastography, utilizes short bursts of vibration to enhance imaging of the liver. Overall, elastography is a sophisticated imaging modality that aids in the evaluation of soft tissue characteristics, contributing to improved diagnostic accuracy.

1. Indications

The elastography ultrasound procedure (CPT® Code 0346T) is indicated for various clinical scenarios where assessment of soft tissue elasticity is necessary. The following conditions may warrant the use of this imaging technique:

Liver Disease - To evaluate liver stiffness, which can indicate fibrosis or cirrhosis.
Breast Abnormalities - To assess the stiffness of breast tissue, aiding in the differentiation between benign and malignant lesions.
Thyroid Disorders - To evaluate thyroid nodules and assess the risk of malignancy based on tissue elasticity.
Prostate Conditions - To assess prostate tissue stiffness, which may assist in the evaluation of prostate cancer.
Musculoskeletal Issues - To evaluate the elasticity of muscles and tendons, particularly in cases of injury or pathology.

2. Procedure

The elastography ultrasound procedure involves several key steps to ensure accurate assessment of tissue elasticity. The following procedural steps outline the process:

Step 1: Patient Preparation - The patient is positioned appropriately to allow optimal access to the area of interest. The skin over the target tissue is typically prepared by cleaning with an antiseptic solution to minimize the risk of infection.
Step 2: Application of Gel - A coupling gel is applied to the skin over the area being examined. This gel facilitates the transmission of ultrasound waves between the transducer and the skin, ensuring high-quality imaging.
Step 3: Ultrasound Imaging - The ultrasound transducer is placed on the skin, and the operator begins to acquire images. Depending on the elastography technique used, the transducer may apply low-frequency compression or utilize focused ultrasound pulses to generate elastographic maps of the tissue.
Step 4: Data Acquisition - The operator captures a series of images that reflect the elastic properties of the tissue. This may involve real-time visualization of the elastographic map or the generation of qualitative color-coded or grayscale images that indicate tissue stiffness.
Step 5: Interpretation of Results - After the imaging is complete, the acquired data is analyzed to assess the elasticity of the tissue. The results are then documented and may be used in conjunction with other diagnostic information to inform clinical decision-making.

3. Post-Procedure

Following the elastography ultrasound procedure, there are typically minimal post-procedure care requirements. Patients may resume normal activities immediately after the procedure, as it is non-invasive and does not usually involve any sedation. However, it is advisable for patients to monitor the site for any unusual symptoms, such as excessive swelling or discomfort. The results of the elastography will be compiled and reported to the referring physician, who will discuss the findings with the patient and determine any necessary follow-up actions or additional diagnostic steps based on the results.

Short Descr	ULTRASOUND ELASTOGRAPHY
Medium Descr	ULTRASOUND ELASTOGRAPHY
Long Descr	Ultrasound, elastography (List separately in addition to code for primary procedure)
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Items and Services Packaged into APC Rates
Berenson-Eggers TOS (BETOS)	I3F - Echography/ultrasonography - other
MUE	Not applicable/unspecified.