CPT® Code 75803

1. Indications

The lymphangiography procedure, represented by CPT® Code 75803, is indicated for various clinical scenarios where visualization of the lymphatic system is necessary. The following conditions may warrant this procedure:

• Evaluation of Lymphatic Obstruction: This procedure is often performed to assess blockages or obstructions within the lymphatic vessels, which can lead to conditions such as lymphedema.
• Investigation of Lymphatic Malformations: Lymphangiography can help in diagnosing congenital or acquired malformations of the lymphatic system.
• Assessment of Tumors: The procedure may be indicated for evaluating the spread of tumors or metastatic disease involving the lymphatic system.
• Preoperative Planning: It can be utilized to map lymphatic drainage patterns prior to surgical interventions, particularly in oncological surgeries.

2. Procedure

The lymphangiography procedure involves several critical steps to ensure accurate imaging of the lymphatic system. The following outlines the procedural steps involved:

• Step 1: Preparation and Cleansing The physician begins by preparing the patient for the procedure. This includes cleansing the skin of the foot to minimize the risk of infection and ensure a sterile environment for the injection.
• Step 2: Injection of Indicator Dye A blue indicator dye is injected between several toes. This dye is crucial for visualizing the lymphatic vessels as it spreads into the small lymph vessels of the foot. The physician observes this process, which typically takes 15 to 30 minutes, to ensure adequate delineation of the lymphatic structures.
• Step 3: Administration of Local Anesthetic Once the lymph vessels are well-defined, a local anesthetic is injected over one of the larger lymph vessels to minimize discomfort during the subsequent steps.
• Step 4: Incision and Exposure The physician makes a small incision in the skin to expose the lymph vessel. This step is critical for accessing the lymphatic system directly.
• Step 5: Injection of Contrast Media 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 vessels during imaging.
• Step 6: 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 process allows for detailed visualization of the lymphatic system.
• Step 7: Interpretation of Results After the imaging is complete, 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, the patient may be monitored for any immediate complications or adverse reactions to the contrast media. It is important to assess the injection site for signs of infection or excessive bleeding. Patients are typically advised to rest and may be given specific instructions regarding activity levels and care of the injection site. Follow-up appointments may be scheduled to discuss the results of the imaging and any further necessary interventions based on the findings. The physician will provide guidance on any additional care or monitoring that may be required following the procedure.