CPT® Code 78205 | Case2Code

Code deleted, see 78803

Official Description

Liver imaging (SPECT);

Common Language Description

Liver imaging using single-photon emission computed tomography (SPECT) is a diagnostic procedure that employs a radiolabeled isotope tracer, specifically 99mTC-sulfur colloid, to visualize the liver's structure and function. This advanced imaging technique is particularly useful for identifying small lesions that may not be visible through traditional planar imaging methods. It is also employed to evaluate liver masses or lesions that have been detected through other imaging modalities such as computed tomography (CT), ultrasound (US), or magnetic resonance imaging (MRI). Additionally, SPECT imaging plays a critical role in monitoring conditions such as cirrhosis and hepatitis C infection, which can significantly affect liver health. The liver, located in the upper right quadrant of the abdomen, is a vital organ responsible for various functions, including bile production, nutrient metabolism, drug and toxin removal from the bloodstream, and the synthesis of proteins essential for blood plasma and clotting regulation. The liver's complex structure consists of two main lobes and numerous smaller lobules interconnected by a network of ducts that facilitate bile drainage into larger ducts, ultimately leading to the hepatic duct. The bile produced by the liver contains enzymes that aid in fat breakdown and transport waste materials to the gallbladder and duodenum. During the SPECT procedure, an intravenous line is established to administer the radiolabeled tracer, which allows for the capture of detailed, three-dimensional images of the liver as gamma cameras rotate around the patient. The imaging process involves scanning at specific intervals to detect the radioactive energy emitted from the liver, which is then converted into visual representations for analysis. It is important to note that when assessing vascular flow in the liver, a different code, 78206, is utilized, as the liver's extensive vascular network, including the portal vein and hepatic artery, can exhibit changes in blood flow due to vessel compromise. Following the imaging, the physician interprets the SPECT results and generates a comprehensive written report detailing the findings.

1. Indications

The liver imaging procedure using SPECT is indicated for several specific clinical scenarios, including:

Identification of Small Lesions This imaging technique is particularly useful for detecting small lesions in the liver that may not be visible through traditional planar imaging methods.
Evaluation of Liver Masses or Lesions SPECT is employed to assess liver masses or lesions that have been previously identified through imaging modalities such as CT, ultrasound, or MRI.
Monitoring of Cirrhosis The procedure is indicated for monitoring patients with cirrhosis, allowing for the assessment of liver function and structure over time.
Assessment of Hepatitis C Infection SPECT imaging is utilized to evaluate the liver in patients with hepatitis C, aiding in the management and treatment of the infection.

2. Procedure

The procedure for liver imaging using SPECT involves several key steps, which are detailed as follows:

Establishment of Intravenous Access An intravenous line is established to facilitate the administration of the radiolabeled isotope tracer, 99mTC-sulfur colloid, which is essential for the imaging process.
Injection of Radiolabeled Isotope Tracer The radiolabeled tracer is injected into the patient's bloodstream through the established intravenous line. This tracer is critical for visualizing the liver during the imaging process.
Waiting Period After the injection, a prescribed waiting period allows the tracer to circulate and accumulate in the liver, ensuring optimal imaging results.
Patient Positioning Once the waiting period is complete, the patient is positioned on the imaging table, ready for the SPECT scan.
Gamma Camera Rotation One or more gamma cameras are then rotated around the patient's body to capture images of the liver. This rotation is crucial for producing a comprehensive three-dimensional image of the liver's structure and function.
Scanning at Specific Intervals Scanning is performed at specific intervals to detect the radioactive energy emitted from the liver. This data is collected and used to create detailed images of the liver.
Image Conversion The radioactive energy detected by the gamma cameras is converted into images that can be analyzed for diagnostic purposes.

3. Post-Procedure

After the SPECT imaging procedure, the patient may be monitored briefly to ensure there are no immediate adverse reactions to the tracer. There are typically no specific post-procedure care requirements, and patients can usually resume normal activities shortly after the imaging is completed. The physician will interpret the SPECT images and provide a written report detailing the findings, which will be used for further clinical decision-making regarding the patient's liver health and any necessary follow-up actions.

Short Descr	LIVER IMAGING (3D)
Medium Descr	LIVER IMAGING SPECT
Long Descr	Liver imaging (SPECT);
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
Type of Service (TOS)	4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS)	I1E - Standard imaging - nuclear medicine
MUE	Not applicable/unspecified.
CCS Clinical Classification	210 - Other radioisotope scan