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The CPT® Code 75860 refers to a specialized radiological procedure known as venography, specifically targeting the venous sinuses, such as the petrosal and inferior sagittal sinuses, or the jugular vein. This procedure involves the use of a catheter to introduce a radiopaque contrast medium, which enhances the visibility of these structures during imaging. Radiological supervision and interpretation are integral components of this procedure, ensuring that the images captured are accurately assessed by a qualified professional. The primary purpose of performing a venography is to diagnose conditions such as hemorrhage or thrombosis, which may arise from various factors including traumatic skull injuries, vascular fistulas, malformations, or tumors. The venous sinuses are critical channels located between the layers of the dura mater in the brain, responsible for draining blood from both external and internal cerebral veins, as well as cerebrospinal fluid from the subarachnoid space. Ultimately, these sinuses direct blood flow into the internal jugular vein (IJV). The inferior sagittal sinus (ISS) plays a significant role in this drainage system, as it empties into the straight sinus, which then connects to the confluence of sinuses and the transverse sinuses before reaching the IJV. Additionally, the superior and inferior petrosal sinuses, which receive drainage from the cavernous sinuses, are also involved in this complex venous network. The superior petrosal sinus drains into the transverse sinuses, while the inferior petrosal sinus drains directly into the IJV. During the procedure, a catheter is typically introduced via a peripheral vein in the arm or directly into the jugular vein. The process begins with the insertion of a fine gauge needle into the chosen blood vessel, followed by the threading of a guidewire through the needle into the jugular vein. To visualize the ISS and cavernous sinuses, contrast may be injected into the carotid arteries. A catheter is then advanced over the guidewire to the designated area for contrast injection, after which the guidewire is removed. The contrast medium is injected, and x-ray films are taken to capture images of the venous structures. Upon completion of the venography, the catheter is removed, and the procedure is documented, including the radiological supervision, interpretation of the images, and a written report detailing the findings.
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The venography procedure described by CPT® Code 75860 is indicated for the evaluation of specific conditions affecting the venous sinuses and jugular vein. The following are the primary indications for performing this procedure:
The venography procedure involves several critical steps to ensure accurate imaging and assessment of the venous structures. The following outlines the procedural steps as described in the CPT® data:
Following the venography procedure, several post-procedure care considerations are important for patient safety and recovery. The patient may be monitored for any immediate complications related to the catheter insertion or contrast injection. It is essential to assess the puncture site for signs of bleeding or infection. Patients may be advised to hydrate adequately to help flush the contrast medium from their system. Additionally, the healthcare provider will review the imaging results and provide a written report detailing the findings, which will be crucial for further management or treatment decisions based on the diagnosis made from the venography.
| Short Descr | VEIN X-RAY NECK | Medium Descr | VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I | Long Descr | Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | T-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I4B - Imaging/procedure - other | MUE | 2 | CCS Clinical Classification | 191 - Arterio- or venogram (not heart and head) |
This is a primary code that can be used with these additional add-on codes.
| 37252 | Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure) | 37253 | Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | RT | Right side (used to identify procedures performed on the right side of the body) | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 2004-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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