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Official Description

Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 75885 involves a specialized imaging technique known as percutaneous transhepatic portography, which is utilized to visualize the portal vein and its collateral veins. This procedure is performed under the supervision of a physician who is responsible for the radiological interpretation of the images obtained. During the process, a catheter is inserted into the portal vein, and a radiopaque contrast material is injected to enhance the visibility of the blood vessels on the radiographs. The physician closely monitors the flow of blood through the portal vein and its collateral pathways, which is crucial for assessing any abnormalities that may be present. Additionally, the procedure allows for the evaluation of varices, which are dilated veins that can occur in the esophagus or stomach, often as a result of increased pressure in the portal vein system. The hemodynamic evaluation component of this procedure includes the measurement of portal vein blood pressure, flow gradients, and flow velocity, providing essential information about the hemodynamics of the portal circulation. The results of the imaging and evaluations are then compiled into a written report by the physician, ensuring that all findings are documented for further clinical decision-making.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for the following conditions:

  • Assessment of Portal Hypertension Evaluation of increased blood pressure in the portal venous system, which can lead to complications such as varices.
  • Investigation of Varices Visualization and assessment of varices in the esophagus or stomach that may pose a risk of bleeding.
  • Evaluation of Portal Vein Thrombosis Identification and assessment of any thrombus formation within the portal vein.
  • Preoperative Planning Providing critical information for surgical planning in patients with liver disease or portal hypertension.

2. Procedure

The procedure involves several key steps that are essential for successful completion:

  • Step 1: Catheter Placement The physician begins by performing a percutaneous approach to access the liver. A needle is inserted into the liver to gain access to the portal vein, followed by the placement of a catheter into the portal vein. This step is crucial as it allows for the subsequent injection of contrast material.
  • Step 2: Injection of Contrast Material Once the catheter is securely positioned within the portal vein, a radiopaque contrast material is injected. This contrast agent enhances the visibility of the portal vein and its branches on radiographic images, allowing for detailed assessment of the vascular structures.
  • Step 3: Radiographic Imaging After the injection of contrast material, a series of radiographs (X-rays) are obtained. These images capture the flow of blood through the portal vein and collateral veins, providing valuable information about the vascular anatomy and any potential abnormalities.
  • Step 4: Hemodynamic Evaluation During the procedure, the physician conducts a hemodynamic evaluation, which includes measuring portal vein blood pressure, flow gradients, and flow velocity. This data is critical for understanding the dynamics of blood flow within the portal circulation.
  • Step 5: Interpretation of Results Following the imaging and evaluation, the physician reviews the radiographs and compiles a written interpretation of the findings. This report includes observations regarding the presence of varices, blood flow characteristics, and any other relevant vascular anomalies.

3. Post-Procedure

After the completion of the percutaneous transhepatic portography, patients are typically monitored for any immediate complications related to the procedure, such as bleeding or infection at the catheter insertion site. The physician may provide specific post-procedure care instructions, which could include recommendations for activity restrictions and signs of potential complications to watch for. Follow-up appointments may be scheduled to discuss the results of the procedure and any further management or treatment options based on the findings.

Short Descr VEIN X-RAY LIVER W/HEMODYNAM
Medium Descr PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I
Long Descr Percutaneous transhepatic portography with hemodynamic evaluation, 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 1
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.
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).
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.
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
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
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2013-01-01 Changed Short Descriptor changed.
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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