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CPT®
78223

CPT® Code 78223
Deleted

Code deleted, see 78226, 78227

Official Description

Hepatobiliary ductal system imaging, including gallbladder, with or without pharmacologic intervention, with or without quantitative measurement of gallbladder function

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 78223 refers to a diagnostic imaging procedure known as hepatobiliary ductal system imaging. This procedure involves the use of radioactive aminoacetic acids, which are injected into the patient to visualize the gallbladder and the associated bile ducts. The imaging is conducted using a specialized camera that captures a series of images as the radioactive substances are metabolized by the liver and subsequently expelled through the bile duct. The primary purpose of this procedure is to assess the functionality of the bile ducts and the gallbladder, providing critical information regarding any potential obstructions, dysfunctions, or abnormalities within the hepatobiliary system. The procedure may also include pharmacologic interventions to enhance the imaging process and may involve quantitative measurements of gallbladder function, allowing for a comprehensive evaluation of the patient's hepatobiliary health.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The hepatobiliary ductal system imaging procedure, coded as CPT® 78223, is indicated for various clinical scenarios where assessment of the bile duct and gallbladder function is necessary. The following conditions may warrant this imaging procedure:

  • Evaluation of Biliary Obstruction This procedure is performed to investigate potential blockages in the bile ducts that may be causing symptoms such as jaundice or abdominal pain.
  • Assessment of Gallbladder Function It is utilized to measure the gallbladder's ability to concentrate and excrete bile, which is crucial for digestion.
  • Investigation of Liver Disease The imaging can help in the evaluation of liver conditions that may affect bile production and flow.
  • Post-Surgical Evaluation This procedure may be indicated following gallbladder surgery to assess the integrity and function of the remaining biliary structures.

2. Procedure

The procedure for hepatobiliary ductal system imaging involves several key steps to ensure accurate assessment of the gallbladder and bile ducts. The following outlines the procedural steps:

  • Step 1: Patient Preparation Prior to the procedure, the patient is typically instructed to fast for a specified period to ensure optimal imaging results. This fasting period allows the gallbladder to fill with bile, enhancing the visibility of the organ during imaging.
  • Step 2: Administration of Radioactive Aminoacetic Acids The physician administers a radioactive tracer, specifically aminoacetic acids, via injection. This tracer is crucial for visualizing the hepatobiliary system as it is processed by the liver.
  • Step 3: Imaging Acquisition Following the injection, a series of images are captured using a specialized gamma camera. These images are taken at various intervals to track the movement of the radioactive tracer through the liver, gallbladder, and bile ducts.
  • Step 4: Pharmacologic Intervention (if applicable) In some cases, pharmacologic agents may be administered to stimulate gallbladder contraction or enhance bile flow, providing additional functional information during the imaging process.
  • Step 5: Quantitative Measurement (if applicable) The procedure may also include quantitative measurements of gallbladder function, assessing parameters such as ejection fraction, which indicates how well the gallbladder is functioning.

3. Post-Procedure

After the hepatobiliary ductal system imaging procedure, patients are typically monitored for a short period to ensure there are no immediate adverse reactions to the radioactive tracer. Most patients can resume normal activities shortly after the procedure, although they may be advised to drink plenty of fluids to help flush the radioactive material from their system. Follow-up appointments may be scheduled to discuss the results of the imaging and any further diagnostic or therapeutic steps that may be necessary based on the findings.
Short Descr HEPATOBILIARY IMAGING
Medium Descr HEPATBL DUX SYS IMG GLBLDR
Long Descr Hepatobiliary ductal system imaging, including gallbladder, with or without pharmacologic intervention, with or without quantitative measurement of gallbladder function
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 Discontinued Code
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 210 - Other radioisotope scan
Date
Action
Notes
2012-01-01 Deleted Code deleted, see 78226, 78227
Pre-1990 Added Code added.
Code
Description
Code
Description
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