CPT® Code 78110

1. Indications

The CPT® Code 78110 is indicated for use in various clinical scenarios where accurate measurement of plasma volume is essential. The following conditions may warrant the performance of this procedure:

• Hypovolemia A condition characterized by a decreased volume of blood plasma, which can lead to inadequate blood flow and oxygen delivery to tissues.
• Hypervolemia An increased volume of blood plasma that may result in fluid overload, potentially causing complications such as heart failure or pulmonary edema.
• Acute Blood Loss Situations where there is a sudden loss of blood volume, necessitating assessment of plasma volume to guide treatment decisions.
• Shock A critical condition where blood flow is insufficient to meet the metabolic demands of tissues, often requiring immediate evaluation of plasma volume to inform resuscitation efforts.

2. Procedure

The procedure for CPT® Code 78110 involves several key steps that are crucial for accurately measuring plasma volume. Each step is outlined as follows:

• Step 1: Patient Preparation The process begins with the careful recording of the patient's height and weight, which are essential for calculating plasma volume. This information helps in determining the appropriate dilution factors for the radiolabeled tracer.
• Step 2: Establishing Venous Access Venous access is established to facilitate the collection of blood samples. This is typically done through a standard venipuncture technique, ensuring that the site is clean and suitable for drawing blood.
• Step 3: Baseline Blood Sample Collection A baseline blood sample is obtained prior to the administration of the radiolabeled pharmaceutical. This sample serves as a reference point for subsequent measurements and is critical for accurate calculations.
• Step 4: Injection of Radiolabeled Pharmaceutical The radiolabeled tracer, commonly I-125 RISA or 99mTc HSA, is injected into the patient. This tracer circulates through the bloodstream, allowing for the measurement of plasma volume based on its dilution.
• Step 5: Blood Sample Collection Post-Injection After allowing sufficient time for circulation, venipuncture is performed again to draw a blood sample. This can be a single sample or multiple samples taken at set intervals, depending on the specific requirements of the test.
• Step 6: Microhematocrit Measurement The microhematocrit is measured from each blood sample collected. This measurement is essential for determining the proportion of red blood cells to plasma in the blood.
• Step 7: Centrifugation The remaining blood is then centrifuged to separate the plasma from the red blood cells. This step is crucial for isolating the plasma for further analysis.
• Step 8: Data Calculation Finally, the data obtained from the patient sample is calculated using specific formulas that compare the dilution factors from the radiolabeled tracer with standardized samples. These calculations take into account the patient's height, weight, and hematocrit levels to provide an accurate assessment of plasma volume.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 78110, the patient may be monitored for any immediate reactions to the radiolabeled tracer, although adverse effects are generally rare. The results of the plasma volume measurement will be analyzed and interpreted by the healthcare provider, who will then discuss the findings with the patient. Depending on the results, further diagnostic testing or treatment may be recommended. It is important for the healthcare team to ensure that the patient is informed about any follow-up care or additional evaluations that may be necessary based on the plasma volume assessment.