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The CPT® Code 75889 refers to a specialized radiological procedure known as hepatic venography, which involves the detailed imaging of the hepatic veins. This procedure can be performed in two ways: wedged or free, depending on the specific technique used to measure hepatic venous pressures. The primary goal of hepatic venography is to evaluate the hemodynamics of the liver, which includes assessing blood flow and pressure within the hepatic veins. During the procedure, a physician conducts radiological supervision and interpretation, ensuring that the imaging is performed accurately and that the results are properly analyzed. To initiate the procedure, a catheter is inserted into the hepatic vein, and a radiopaque contrast material is injected to enhance the visibility of the veins on the radiographs. The physician monitors the flow of blood through the hepatic veins and their branches, which is crucial for diagnosing various hepatic conditions. The procedure also involves obtaining wedged or free hepatic venous pressures, which are essential for understanding the hemodynamic status of the liver. In the case of wedged hepatic venous pressure measurement, a balloon-tipped catheter is used to occlude a distal hepatic vein branch, allowing for the assessment of pressure in that specific area. Conversely, free hepatic venous pressure is measured without balloon inflation, providing a different perspective on the venous pressure dynamics. The physician utilizes fluoroscopic imaging to ensure the catheter is correctly positioned and to visualize the flow of contrast material, which should demonstrate parenchymal blushing without any reflux. Ultimately, the physician reviews the obtained radiographs and compiles a written interpretation of the findings, which may include calculations of the hepatic venous pressure gradient to estimate portal venous pressure. This comprehensive evaluation is critical for diagnosing and managing various liver-related conditions.
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The procedure described by CPT® Code 75889 is indicated for various clinical scenarios where assessment of hepatic venous pressures and blood flow dynamics is necessary. The following conditions may warrant the performance of hepatic venography with hemodynamic evaluation:
The procedure for CPT® Code 75889 involves several critical steps to ensure accurate hepatic venography and hemodynamic evaluation. The following outlines the procedural steps:
After the completion of the hepatic venography procedure, several post-procedure care considerations are important for patient safety and recovery. The physician will monitor the patient for any immediate complications, such as bleeding or hematoma at the catheter insertion site. Patients may be advised to rest and avoid strenuous activities for a short period following the procedure. Additionally, the physician will review the results of the imaging and hemodynamic evaluation with the patient, discussing any necessary follow-up or further diagnostic steps based on the findings. It is also essential to ensure that the patient is aware of any signs or symptoms that may require immediate medical attention, such as severe pain or unusual swelling at the catheter site.
| Short Descr | VEIN X-RAY LIVER W/HEMODYNAM | Medium Descr | HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I | Long Descr | Hepatic venography, wedged or free, 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. | 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. | 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). | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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