CPT® Code 78104

1. Indications

The indications for bone marrow imaging using CPT® Code 78104 include the following:

• Diagnosis of Bone Marrow Disorders This procedure is performed to identify and diagnose various bone marrow disorders, which may include conditions such as leukemia, lymphoma, and myelodysplastic syndromes.
• Staging of Bone Marrow Disorders Bone marrow imaging is utilized to stage the extent of bone marrow involvement in diseases, aiding in treatment planning and prognosis.
• Detection of Infections The imaging technique can help identify infections that may be affecting the bone marrow, providing critical information for appropriate management.
• Identification of Metastases Bone marrow imaging is essential for detecting 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 used to assess the success of bone marrow transplants, monitoring for engraftment and any potential complications.
• Monitoring Effects of Radiotherapy Bone marrow imaging can evaluate the impact of radiotherapy on bone marrow health and function, ensuring that treatment is effective and identifying any adverse 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 whole body bone marrow imaging using CPT® Code 78104 involves several key steps, each critical for ensuring accurate imaging and diagnosis:

• Step 1: Blood Sample Collection The process begins with the collection of a blood sample from the patient. This sample is essential for isolating the white blood cells (WBCs) that will be used in the imaging procedure.
• Step 2: Separation of Blood Components Once the blood sample is obtained, it is processed to separate the WBCs from the red blood cells (RBCs). This separation is crucial as the WBCs are the target cells for imaging.
• Step 3: Tagging WBCs with Radionuclide The isolated WBCs are then tagged with a radionuclide-labeled tracer. This tagging allows the WBCs to be visualized during the imaging process, as the radionuclide emits signals that can be detected by imaging equipment.
• Step 4: Intravenous Injection After tagging, the radionuclide-labeled WBCs are injected back into the patient’s bloodstream through an intravenous line. This step ensures that the tagged cells circulate throughout the body, allowing for comprehensive imaging.
• Step 5: Administration of Additional Isotopes (if necessary) In some cases, other isotopes may also be administered intravenously to enhance imaging quality or provide additional diagnostic information.
• 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 capture detailed images of the bone marrow's functional activity at specific intervals after the injection.
• Step 7: Interpretation of Images The final step involves the physician interpreting the images obtained from the SPECT, PET, or other imaging modalities. The physician analyzes the findings and compiles a written report that details the results of the imaging study.

3. Post-Procedure

After the completion of the bone marrow imaging procedure, patients may be monitored for any immediate reactions to the radionuclide injection. Generally, there are no specific post-procedure care requirements, and patients can resume normal activities unless otherwise instructed by their healthcare provider. The results of the imaging study will be reviewed by the physician, who will discuss the findings with the patient and determine any necessary follow-up actions or additional diagnostic steps based on the results. It is important for patients to understand that the imaging may be repeated at certain intervals to monitor ongoing conditions or assess treatment efficacy.