CPT® Code 76979 | Case2Code

Official Description

Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)

Common Language Description

Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac) is a specialized imaging technique that utilizes a contrast agent composed of microbubbles. These microbubbles are tiny spheres or bubbles filled with gas, encased in a stable shell made of lipids, proteins, or polymers. They are designed to enhance the quality of ultrasound (US) imaging by improving the visualization of specific organs or tissues. The microbubbles are tagged with ligands that have a high affinity for particular receptors, allowing them to bind selectively to target areas within the body. When the contrast agent is injected intravenously, the ultrasound probe is positioned over the area of interest. If the microbubbles successfully bind to their target receptors, they will accumulate in that region, leading to a change in how ultrasound waves are reflected through the tissue. This results in increased echogenicity, which creates a distinctive acoustic signature that can be detected during the ultrasound examination. This technique is particularly useful for identifying tumors and nodules in organs such as the liver, pancreas, kidneys, and ovaries. Additionally, it can be employed to evaluate inflammatory lesions and tumors in the gastrointestinal tract, as well as to assess abdominal parenchyma for hematomas and vascular injuries following trauma. The CPT® code 76978 is used to report the ultrasound characterization of an initial non-cardiac lesion, while CPT® code 76979 is designated for each additional lesion that requires a separate injection of the contrast agent.

1. Indications

Targeted dynamic microbubble sonographic contrast characterization is indicated for various clinical scenarios where enhanced imaging is necessary to evaluate specific lesions or conditions. The following indications are explicitly recognized for this procedure:

Evaluation of Tumors and Nodules This procedure is indicated for the assessment of tumors and nodules located in the liver, pancreas, kidneys, and ovaries, where improved visualization can aid in diagnosis and treatment planning.
Inflammatory Lesions It may also be utilized to characterize inflammatory lesions and tumors within the gastrointestinal tract, providing critical information for management.
Assessment of Abdominal Parenchyma The technique is beneficial for assessing abdominal parenchyma for hematomas and vascular injuries, particularly following trauma, to determine the extent of injury and guide further intervention.

2. Procedure

The procedure for targeted dynamic microbubble sonographic contrast characterization involves several key steps to ensure accurate imaging and assessment of the targeted lesions. The following procedural steps are outlined:

Step 1: Preparation of the Patient The patient is positioned appropriately for the ultrasound examination, and the area of interest is identified. The healthcare provider may explain the procedure to the patient to ensure understanding and cooperation.
Step 2: Administration of Contrast Agent An intravenous line is established, and the microbubble contrast agent is injected into the patient's bloodstream. This agent is designed to enhance the ultrasound images by improving the echogenicity of the targeted tissues.
Step 3: Ultrasound Imaging The ultrasound probe is then placed over the targeted organ or tissue. The sonographer or physician performs the ultrasound examination, capturing images as the microbubbles circulate and accumulate in the area of interest. The dynamic nature of the microbubbles allows for real-time imaging, which can provide valuable information about the characteristics of the lesions.
Step 4: Evaluation of Results After the imaging is complete, the captured ultrasound images are analyzed. The presence and behavior of the microbubbles in relation to the targeted lesions are assessed to determine their nature and any potential implications for treatment.

3. Post-Procedure

Post-procedure care for patients undergoing targeted dynamic microbubble sonographic contrast characterization typically involves monitoring for any immediate adverse reactions to the contrast agent. Patients may be observed for a short period to ensure they do not experience any side effects. Additionally, the healthcare provider may discuss the results of the ultrasound examination with the patient, outlining any necessary follow-up actions or further diagnostic steps based on the findings. It is important to ensure that patients are informed about any potential symptoms to watch for after the procedure, such as allergic reactions or unusual discomfort, and to provide guidance on when to seek medical attention if needed.

Short Descr	US TRGT DYN MBUBB EA ADDL
Medium Descr	ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES
Long Descr	Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (List separately in addition to code for primary procedure)
Status Code	Active Code
Global Days	ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures 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	Items and Services Packaged into APC Rates
ASC Payment Indicator	Packaged service/item; no separate payment made.
Type of Service (TOS)	4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS)	none
MUE	3

This is an add-on code that must be used in conjunction with one of these primary codes.

76978

MPFS Status: Active Code APC S ASC Z2 Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion

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.
GC	This service has been performed in part by a resident under the direction of a teaching physician
LT	Left side (used to identify procedures performed on the left side of the body)