© Copyright 2025 American Medical Association. All rights reserved.
Liver imaging with vascular flow, as described by CPT® Code 78202, involves the use of scintigraphy and a radiolabeled isotope tracer, specifically 99mTc-sulfur colloid. This imaging technique is essential for assessing the liver's size and identifying various abnormalities such as tumors, abscesses, hematomas, or cysts. The liver plays a critical role in the body, including the production of bile, metabolism of nutrients, detoxification of drugs and toxins from the bloodstream, and the synthesis of proteins necessary for blood plasma and clotting regulation. Anatomically, the liver is situated in the upper right quadrant of the abdomen and consists of two main lobes, which are further divided into smaller lobules. These lobules are interconnected by a network of small ducts that facilitate the drainage of bile into larger ducts, ultimately leading to the hepatic duct. Bile, produced by the liver, contains enzymes that aid in the breakdown of fats and assist in the transport of waste materials to the gallbladder and duodenum. During the procedure, an intravenous line is established to administer the radiolabeled isotope tracer. Following a designated waiting period, the patient is positioned on the imaging table, with the gamma camera placed over the upper right abdomen. Scanning is conducted at specific intervals to capture images of the liver, utilizing the radioactive energy emitted from the organ. The vascular nature of the liver, characterized by the portal vein and hepatic artery, is crucial for understanding blood flow dynamics; any compromise in one vessel can lead to alterations in the blood flow of adjacent vessels. The physician is responsible for interpreting the scintigraphy results and generating a comprehensive written report detailing the findings.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure for liver imaging with vascular flow (CPT® Code 78202) is indicated for the following conditions:
The procedure for liver imaging with vascular flow involves several key steps that ensure accurate imaging and assessment of the liver's condition:
Post-procedure care for liver imaging with vascular flow typically involves monitoring the patient for any immediate reactions to the radiolabeled tracer. Patients may be advised to hydrate adequately to help flush the tracer from their system. Additionally, the physician will provide a written report detailing the findings from the imaging, which will be used for further diagnostic or treatment planning. Follow-up appointments may be scheduled to discuss the results and any necessary next steps based on the findings.
| Short Descr | LIVER IMAGING WITH VASC FLOW | Medium Descr | LIVER IMAGING W/VASCULAR FLOW | Long Descr | Liver imaging; with 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 | 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. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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 | 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 | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |