CPT® Code 78075

Official Description

Adrenal imaging, cortex and/or medulla

Common Language Description

Adrenal imaging, specifically targeting the cortex and/or medulla, is a diagnostic procedure utilized to visualize and assess the adrenal glands, which are situated above each kidney. These glands play a crucial role in hormone production, secreting vital hormones such as cortisol, aldosterone, and androgens. The imaging process is essential for detecting or defining lesions that may be present in the adrenal glands. Lesions in the adrenal cortex are often non-functioning adenomas or metastatic tumors that can cause enlargement of the gland without necessarily increasing hormone production. In contrast, the adrenal medulla is responsible for the secretion of catecholamines, including epinephrine and norepinephrine. Masses found in the medulla are typically hyperfunctioning, with conditions such as pheochromocytomas and aldosteronomas being common. These tumors can lead to excessive hormone production, impacting the patient's health. For the diagnosis of suspected pheochromocytoma, a patient may receive an intravenous injection of the radioisotope Iodine-131, followed by a whole-body scan using computed tomography (CT) 24 to 72 hours later. Additionally, to accurately localize a pheochromocytoma, an injection of Indium-111 may be administered, either alone or in combination with I-131, with subsequent imaging performed 4 to 24 hours later via CT. The radioisotope I-131 can also be utilized to identify aldosteronomas and other hyperfunctioning tumors of the adrenal cortex. Furthermore, positron emission tomography (PET) scanning employs the radioisotope fluorine-18 to help differentiate between benign and malignant non-hyperfunctioning adrenal masses. The results of these imaging studies are interpreted by the physician, who provides a comprehensive written report detailing the findings.

1. Indications

The adrenal imaging procedure is indicated for various clinical scenarios where assessment of the adrenal glands is necessary. The following conditions may warrant this imaging:

Detection of Adrenal Lesions Imaging is performed to identify and characterize lesions present in the adrenal glands, which may include tumors or other abnormalities.
Evaluation of Hormonal Disorders The procedure is indicated in cases where there is suspicion of hyperfunctioning adrenal tumors, such as pheochromocytomas or aldosteronomas, which can lead to hormonal imbalances.
Assessment of Metastatic Disease Imaging may be necessary to evaluate the adrenal glands for metastatic lesions originating from other primary cancers.
Follow-Up of Known Adrenal Masses Patients with previously identified adrenal masses may require imaging to monitor changes in size or characteristics over time.

2. Procedure

The adrenal imaging procedure involves several key steps to ensure accurate visualization and assessment of the adrenal glands. The following procedural steps are typically followed:

Step 1: Patient Preparation Prior to the imaging procedure, the patient may be instructed to refrain from certain medications or foods that could interfere with the imaging results. It is essential to ensure that the patient is adequately hydrated and understands the procedure.
Step 2: Administration of Radioisotope For suspected pheochromocytoma, the patient receives an intravenous injection of the radioisotope Iodine-131. This radioisotope helps to enhance the imaging of the adrenal glands. In cases where localization of pheochromocytoma is required, Indium-111 may be administered either alone or in conjunction with I-131.
Step 3: Imaging Acquisition After the administration of the radioisotope, a whole-body scan is performed using computed tomography (CT). For I-131, this scan typically occurs 24 to 72 hours post-injection, while for Indium-111, the imaging is conducted 4 to 24 hours later. This timing is crucial for optimal visualization of the adrenal glands.
Step 4: Interpretation of Images Once the imaging is complete, the physician reviews the CT or PET images to identify any abnormalities or lesions in the adrenal glands. This interpretation is critical for determining the presence of tumors and their functional status.
Step 5: Reporting Findings The physician compiles a written report detailing the findings from the imaging study. This report includes observations regarding the size, location, and characteristics of any identified lesions, as well as recommendations for further management if necessary.

3. Post-Procedure

After the adrenal imaging procedure, patients may be monitored for any immediate reactions to the radioisotope. Generally, there are no specific post-procedure care requirements, but patients may be advised to drink plenty of fluids to help flush the radioisotope from their system. The physician will discuss the results of the imaging study with the patient during a follow-up appointment, where further management or treatment options may be considered based on the findings. It is important for patients to report any unusual symptoms or concerns following the procedure to their healthcare provider.

Short Descr	ADRENAL CORTEX & MEDULLA IMG
Medium Descr	ADRENAL IMAGING CORTEX &/MEDULLA
Long Descr	Adrenal imaging, cortex and/or medulla
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)	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	Procedure or Service, Not Discounted when Multiple
ASC Payment Indicator	Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight.
Type of Service (TOS)	4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS)	I1E - Standard imaging - nuclear medicine
MUE	1
CCS Clinical Classification	209 - Radioisotope scan and function studies

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
MG	The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
MH	Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider