CPT® Code 75801

1. Indications

The procedure of lymphangiography, as described by CPT® Code 75801, is indicated for various clinical scenarios where visualization of the lymphatic system is necessary. The following conditions may warrant the performance of this procedure:

• Evaluation of Lymphedema - Lymphangiography is often performed to assess the presence and extent of lymphedema, which is the swelling that occurs due to the accumulation of lymph fluid in the tissues.
• Investigation of Lymphatic Obstruction - This procedure can help identify blockages or abnormalities in the lymphatic vessels that may be causing issues such as swelling or infection.
• Assessment of Lymphatic Malformations - Lymphangiography is useful in diagnosing congenital or acquired malformations of the lymphatic system, which can lead to various complications.
• Preoperative Planning - The procedure may be indicated prior to surgical interventions involving the lymphatic system to provide detailed anatomical information.

2. Procedure

The lymphangiography procedure, as outlined in CPT® Code 75801, involves several critical steps to ensure accurate imaging of the lymphatic system. The following procedural steps are performed:

• Step 1: Skin Preparation - The procedure begins with the cleansing of the skin on the foot to minimize the risk of infection. This step is crucial for maintaining a sterile environment during the injection process.
• Step 2: Injection of Indicator Dye - A blue indicator dye is injected between several toes. This dye serves as a tracer to visualize the lymphatic vessels as it spreads through the lymphatic system.
• Step 3: Observation of Dye Spread - The physician observes the spread of the dye, which typically takes 15 to 30 minutes. This observation is essential to ensure that the lymph vessels are adequately delineated for imaging.
• Step 4: Local Anesthetic Administration - Once the lymph vessels are well visualized, a local anesthetic is injected over one of the larger lymph vessels to minimize discomfort during the subsequent steps.
• Step 5: Incision and Exposure - The skin is incised to expose the lymph vessel, allowing for direct access to the lymphatic system for further intervention.
• Step 6: Contrast Media Injection - A needle or catheter is inserted into the exposed lymph vessel, and contrast media is injected. This contrast agent enhances the visibility of the lymphatic structures during imaging.
• Step 7: Radiographic Imaging - Radiographs are obtained over a period of 1 to 2 hours as the contrast travels through the lymph vessels of the leg. This imaging captures the flow and structure of the lymphatic system.
• Step 8: Interpretation of Results - Finally, the physician reviews the radiographs and provides a written interpretation of the findings, which is essential for diagnosing any underlying conditions.

3. Post-Procedure

After the lymphangiography procedure is completed, several post-procedure care considerations are important for patient recovery and monitoring. Patients may be observed for any immediate adverse reactions to the dye or contrast media used during the procedure. It is also essential to monitor the injection site for signs of infection or excessive swelling. Patients are typically advised to rest and avoid strenuous activities for a short period following the procedure. The physician will provide specific instructions regarding follow-up appointments to discuss the results of the imaging and any further necessary interventions based on the findings. Additionally, patients may be informed about potential side effects or complications that could arise, ensuring they are well-informed about their recovery process.