CPT® Code 75733

1. Indications

The indications for performing bilateral selective adrenal angiography (CPT® Code 75733) include the following conditions and symptoms:

• Adrenal Hyperplasia - A condition characterized by the enlargement of the adrenal glands, which may lead to hormonal imbalances.
• Adrenal Adenomas - Benign tumors of the adrenal glands that can affect hormone production and may require further evaluation.
• Pheochromocytomas - Tumors that arise from the adrenal medulla and can cause excessive production of catecholamines, leading to hypertension and other symptoms.
• Metastatic Lesions - Cancerous growths that have spread to the adrenal glands from other primary sites, necessitating assessment for treatment planning.

2. Procedure

The procedure for bilateral selective adrenal angiography involves several critical steps to ensure accurate visualization of the adrenal vasculature:

• Step 1: Patient Preparation - The patient is positioned appropriately, and the groin area is cleaned and sterilized to minimize the risk of infection. Sedation may be administered to ensure patient comfort during the procedure.
• Step 2: Accessing the Blood Vessel - A large bore needle is inserted into a suitable blood vessel, typically in the femoral region of the groin. This access point allows for the introduction of the necessary instruments into the vascular system.
• Step 3: Guidewire Introduction - A guidewire is carefully threaded through the needle into the blood vessel. This guidewire serves as a pathway for the subsequent catheter placement.
• Step 4: Catheter Advancement - A catheter is advanced over the guidewire into the abdominal aorta, utilizing fluoroscopic guidance to ensure accurate positioning within the vascular system.
• Step 5: Selective Catheterization - Once the catheter is in place, selective catheterization of the adrenal arteries is performed. This involves navigating the catheter into the specific branches that supply the adrenal glands, including the superior suprarenal artery, middle suprarenal artery, and inferior suprarenal artery.
• Step 6: Contrast Injection - A radiopaque contrast medium (dye) is injected through the catheter into the selected adrenal arteries. This contrast enhances the visibility of the adrenal glands and surrounding tissues during imaging.
• Step 7: Imaging and Interpretation - Fluoroscopic imaging is conducted to capture real-time images of the adrenal vasculature. The radiologist supervises the procedure, reviews the images, and interprets the findings to provide a comprehensive assessment.
• Step 8: Documentation - A detailed written report is generated, summarizing the findings from the angiography, which is essential for further clinical decision-making.

3. Post-Procedure

After the completion of the bilateral selective adrenal angiography, the patient is monitored for any immediate complications, such as bleeding or hematoma at the access site. The patient may be advised to rest and avoid strenuous activities for a specified period. Follow-up care may include reviewing the imaging results with the healthcare provider to discuss any necessary further evaluations or treatments based on the findings. It is also important for the patient to report any unusual symptoms or concerns during the recovery phase.