CPT® Code 78206 | Case2Code

Code deleted, see 78803

Official Description

Liver imaging (SPECT); with vascular flow

Common Language Description

Liver imaging using single-photon emission computed tomography (SPECT) is a specialized diagnostic procedure that employs a radiolabeled isotope tracer, specifically 99mTC-sulfur colloid, to visualize the liver's structure and function. This imaging technique is particularly valuable for identifying small lesions that may not be visible through traditional planar imaging methods. It is also utilized to evaluate liver masses or lesions that have been previously detected through other imaging modalities such as computed tomography (CT), ultrasound (US), or magnetic resonance imaging (MRI). Additionally, SPECT liver imaging plays a crucial role in monitoring chronic liver conditions, including cirrhosis and hepatitis C infection. 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, followed by a waiting period before the patient is positioned on the imaging table. One or more gamma cameras then rotate around the patient to capture a three-dimensional image of the liver. This imaging process allows for the assessment of vascular flow within the liver, which is critical given the organ's rich blood supply from the portal vein and hepatic artery. Any compromise in blood flow from one vessel can significantly affect the surrounding vascular structures. The physician interprets the resulting SPECT images and generates a comprehensive written report detailing the findings.

1. Indications

The SPECT liver imaging procedure 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 imaging is employed to assess liver masses or lesions that have been previously identified through other imaging modalities such as CT, US, or MRI.
Monitoring of Chronic Liver Conditions The procedure is also indicated for monitoring patients with chronic liver diseases, including cirrhosis and hepatitis C infection, to evaluate disease progression or response to treatment.

2. Procedure

The SPECT liver imaging procedure involves several key steps to ensure accurate imaging and assessment of liver function and structure:

Establishment of Intravenous Access An intravenous line is established in the patient 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 intravenous line, allowing it to circulate through the bloodstream and accumulate in the liver tissue, where it will emit gamma radiation.
Waiting Period After the injection, a prescribed waiting period is observed to allow adequate distribution of the tracer within 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 from multiple angles, which are necessary for creating a comprehensive three-dimensional representation of the liver.
Image Acquisition Scanning is performed at specific intervals, during which the gamma cameras detect the radioactive energy emitted from the liver and convert it into detailed images for analysis.

3. Post-Procedure

After the SPECT liver imaging procedure, patients may be monitored briefly to ensure there are no immediate adverse reactions to the radiolabeled tracer. There are typically no specific post-procedure care requirements, and patients can usually resume their 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.

Short Descr	LIVER IMAGE (3D) WITH FLOW
Medium Descr	LIVER IMAGING SPECT W/VASCULAR FLOW
Long Descr	Liver imaging (SPECT); 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
Type of Service (TOS)	4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS)	I1E - Standard imaging - nuclear medicine
MUE	Not applicable/unspecified.
CCS Clinical Classification	209 - Radioisotope scan and function studies