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Official Description

Acute gastrointestinal blood loss imaging

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Acute gastrointestinal blood loss imaging is a diagnostic procedure utilized to identify and evaluate instances of acute gastrointestinal bleeding. This imaging technique employs scintigraphy, which is a form of nuclear medicine that utilizes a radiolabeled isotope tracer, specifically 99mTc-sulfur colloid. The process begins with the establishment of an intravenous line through which the radiolabeled tracer is injected directly into the patient's circulatory system. Alternatively, a blood sample may be collected, and the red blood cells (RBCs) are separated using centrifugation. These tagged RBCs are then reintroduced into the patient’s bloodstream. Following the injection of the tracer, the patient is positioned on an imaging table, and a gamma camera is placed over the anterior abdomen and pelvis. The imaging is conducted at predetermined intervals, capturing the radioactive energy emitted from the tracer, which is then transformed into visual images or a movie mode display. The physician is responsible for interpreting the results of the blood loss imaging study and generating a comprehensive written report detailing the findings, which is crucial for determining the source and extent of gastrointestinal bleeding.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Acute gastrointestinal blood loss imaging is indicated for the evaluation of patients presenting with symptoms or conditions that suggest acute gastrointestinal bleeding. The following are specific indications for this procedure:

  • Acute gastrointestinal bleeding Patients exhibiting signs of acute gastrointestinal bleeding, such as hematemesis (vomiting blood), melena (black, tarry stools), or hematochezia (passage of fresh blood from the rectum), may require this imaging to locate the source of the bleeding.
  • Unexplained anemia Individuals with unexplained anemia, particularly when there is a suspicion of gastrointestinal blood loss, may benefit from this imaging to identify potential bleeding sites.
  • Monitoring of known gastrointestinal lesions Patients with previously diagnosed gastrointestinal lesions, such as ulcers or tumors, may undergo this imaging to assess for any acute bleeding episodes related to these conditions.

2. Procedure

The procedure for acute gastrointestinal blood loss imaging involves several critical steps to ensure accurate diagnosis and assessment of gastrointestinal bleeding. The following outlines the procedural steps:

  • Step 1: Establish intravenous access An intravenous line is established in the patient’s arm or hand to facilitate the administration of the radiolabeled isotope tracer. This step is essential for ensuring that the tracer can be delivered directly into the circulatory system.
  • Step 2: Injection of the radiolabeled tracer The radiolabeled isotope tracer, 99mTc-sulfur colloid, is injected into the patient’s bloodstream through the established intravenous line. This tracer is crucial for imaging as it allows for the visualization of blood flow and potential bleeding sites within the gastrointestinal tract.
  • Step 3: Alternative method of tracer administration In some cases, a blood sample may be drawn from the patient, which is then centrifuged to separate the red blood cells. These RBCs are tagged with the radiolabeled isotope and subsequently injected back into the patient. This alternative method ensures that the tracer is effectively incorporated into the patient’s blood circulation.
  • Step 4: Imaging procedure After the tracer has been administered, the patient is positioned on the imaging table with the gamma camera placed over the anterior abdomen and pelvis. Scanning is performed at specific intervals to capture the distribution of the tracer within the gastrointestinal tract. The gamma camera detects the radioactive energy emitted from the tracer, converting it into images or a movie mode display for analysis.
  • Step 5: Interpretation of results Following the imaging, the physician interprets the blood loss imaging study. This interpretation involves analyzing the captured images to identify any areas of abnormal tracer accumulation, which may indicate the presence of gastrointestinal bleeding. A written report detailing the findings is then generated for further clinical evaluation.

3. Post-Procedure

After the acute gastrointestinal blood loss imaging procedure, patients may be monitored for any immediate reactions to the radiolabeled tracer. It is generally recommended that patients remain hydrated and resume normal activities unless otherwise directed by their physician. The results of the imaging study will be reviewed, and the physician will discuss the findings with the patient, including any necessary follow-up actions or additional diagnostic procedures that may be required based on the results. Patients should be informed about the importance of reporting any new or worsening symptoms following the procedure.

Short Descr ACUTE GI BLOOD LOSS IMAGING
Medium Descr ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING
Long Descr Acute gastrointestinal blood loss imaging
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 2
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.
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
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
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
GC This service has been performed in part by a resident under the direction of a teaching physician
MF The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
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).
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
MC Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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