CPT® Code 78103

1. Indications

The indications for performing bone marrow imaging using CPT® Code 78103 include the following:

• Diagnosis of Bone Marrow Disorders This procedure is utilized to diagnose various bone marrow disorders, which may include conditions such as leukemia, lymphoma, and myelodysplastic syndromes.
• Staging of Bone Marrow Disorders Bone marrow imaging aids in staging the extent of bone marrow involvement in diseases, providing critical information for treatment planning.
• Detection of Infections The imaging technique is employed to identify infections that may affect the bone marrow, allowing for timely intervention.
• Identification of Metastases Bone marrow imaging is used to detect the presence of metastatic disease, where cancer cells spread to the bone marrow from other parts of the body.
• Evaluation of Bone Marrow Transplant Success This procedure is essential for assessing the success of bone marrow transplants, monitoring engraftment, and identifying potential complications.
• Monitoring Effects of Radiotherapy Bone marrow imaging can be used to monitor the effects of radiotherapy on the bone marrow, helping to evaluate treatment efficacy and side effects.
• Assessment of Aplastic Anemia and Myelofibrosis The imaging technique is valuable in evaluating conditions such as aplastic anemia and myelofibrosis, providing insights into bone marrow function and cellularity.

2. Procedure

The procedure for bone marrow imaging using CPT® Code 78103 involves several key steps, which are detailed as follows:

• Step 1: Blood Sample Collection The process begins with the collection of a blood sample from the patient. This sample is crucial for the subsequent steps, as it contains the white blood cells (WBCs) that will be used for imaging.
• Step 2: Separation of White Blood Cells The collected blood sample is processed to separate the WBCs from the red blood cells (RBCs). This separation is typically achieved through centrifugation, which allows for the isolation of the cellular components.
• Step 3: Tagging WBCs with Radionuclide Once the WBCs are isolated, they are tagged with a radionuclide-labeled tracer. This tagging is essential for the imaging process, as it enables the visualization of the WBCs during the scanning phase.
• Step 4: Intravenous Injection The tagged WBCs are then injected back into the patient’s bloodstream via an intravenous route. This step ensures that the tracer-labeled cells circulate throughout the body and accumulate in the bone marrow.
• Step 5: Administration of Additional Isotopes (if applicable) In some cases, other isotopes may also be administered intravenously to enhance the imaging results or provide additional information about the bone marrow.
• Step 6: Imaging with SPECT and/or PET Following the injection, imaging is performed using Single Photon Emission Computed Tomography (SPECT) and/or Positron Emission Tomography (PET) scanning. These advanced imaging techniques are conducted at specific intervals to capture the functional activity of the bone marrow.
• Step 7: Interpretation of Images After the imaging is completed, a physician interprets the ECT, SPECT, CT, or PET scan images. This interpretation is critical for diagnosing and assessing the conditions affecting the bone marrow.
• Step 8: Reporting Findings Finally, the physician compiles a written report detailing the findings from the imaging study. This report is essential for guiding further clinical management and treatment decisions.

3. Post-Procedure

Post-procedure care following bone marrow imaging with CPT® Code 78103 typically involves monitoring the patient for any immediate reactions to the radionuclide tracer. Patients may be advised to drink plenty of fluids to help flush the tracer from their system. There are generally no significant recovery concerns associated with this non-invasive imaging procedure, and patients can usually resume their normal activities shortly after the imaging is completed. However, specific follow-up instructions may be provided based on the individual patient's condition and the findings from the imaging study. It is also important for the physician to discuss the results of the imaging with the patient and outline any necessary next steps in their care plan.