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Spleen imaging, as described by CPT® Code 78185, involves the use of a specialized imaging technique to visualize the spleen, which is an organ involved in filtering blood and supporting the immune system. This procedure can be performed with or without vascular flow studies, utilizing heat-damaged red blood cells (RBCs) that are labeled with the radioisotope technetium-99m (99m-Tc). The process begins with the collection of a blood sample, which can be obtained through venipuncture or via an intravenous line. The collected blood is treated with the radioisotope tracer and incubated in a heated water bath to facilitate the labeling of the RBCs. Once prepared, the labeled RBCs are injected back into the patient. The imaging is conducted using Single Photon Emission Computed Tomography (SPECT), which allows for detailed visualization of the spleen's structure and function. This imaging technique is particularly useful for assessing the size and shape of the spleen, ruling out congenital conditions such as asplenia (absence of the spleen) or polysplenia (multiple small spleens) in pediatric patients, and monitoring adults who have undergone splenectomy due to conditions like thrombocytopenia. Additionally, the procedure can help identify and evaluate abdominal masses that may contain functioning splenic tissue. SPECT scanning typically occurs 30 to 120 minutes post-injection, capturing images from various angles, including anterior, posterior, and posterior oblique views. In cases where ectopic splenic tissue is suspected, the entire abdomen is scanned, and for patients with a history of abdominal trauma, the chest may also be included in the imaging. The resulting SPECT images can be compared with previous imaging studies such as CT or MRI to provide a comprehensive assessment. Finally, the interpreting physician generates a written report detailing the findings, including the timing of the imaging relative to the injection and specific characteristics of any identified functioning splenic tissue.
© Copyright 2025 Coding Ahead. All rights reserved.
The spleen imaging procedure using CPT® Code 78185 is indicated for several clinical scenarios, particularly when there is a need to evaluate the spleen's structure and function. The following conditions and situations warrant this imaging study:
The procedure for spleen imaging using CPT® Code 78185 involves several detailed steps to ensure accurate imaging and assessment of the spleen. The following outlines the procedural steps:
After the spleen imaging procedure, patients may be monitored for any immediate reactions to the radioisotope injection, although serious side effects are rare. The physician will review the SPECT images and generate a written report that outlines the findings, including any functioning splenic tissue and its characteristics. Patients may be advised to follow up with their healthcare provider to discuss the results and any further management or treatment options based on the imaging findings. It is also important for patients to be informed about the potential need for additional imaging studies or evaluations, depending on the results of the spleen imaging.
| Short Descr | SPLEEN IMAGING | Medium Descr | SPLEEN IMAGING ONLY W/WO VASCULAR FLOW | Long Descr | Spleen imaging only, with or without vascular flow | 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 | 210 - Other radioisotope scan |
| 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. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 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 |
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| Pre-1990 | Added | Code added. |