CPT® Code 78282

1. Indications

Gastrointestinal protein loss imaging is indicated for the evaluation of conditions that may lead to protein-losing enteropathy. The following are specific indications for performing this procedure:

• Crohn's Disease This inflammatory bowel disease can cause damage to the intestinal lining, leading to protein loss.
• Ulcerative Colitis Another form of inflammatory bowel disease, ulcerative colitis can also result in protein leakage from the gastrointestinal tract.
• Ileocecal Tuberculosis This infectious disease can affect the ileocecal region of the intestines, contributing to protein loss.
• Symptoms of Edema Patients presenting with swelling due to fluid retention may require this imaging to assess for underlying protein loss.
• Hypoalbuminemia Low levels of albumin in the blood, particularly when not attributable to hepatic or renal disease, may necessitate this evaluation.

2. Procedure

The procedure for assessing gastrointestinal protein loss involves several key steps, each critical for accurate imaging and diagnosis.

• Step 1: Establishing an Intravenous Line An intravenous (IV) line is first established to facilitate the administration of the radiolabeled dextran directly into the patient's circulatory system. This step is essential for ensuring that the tracer is delivered effectively for imaging purposes.
• Step 2: Injection of Radiolabeled Dextran The radiolabeled dextran is injected through the IV line. This tracer is designed to bind to proteins in the bloodstream, allowing for the visualization of protein loss in the gastrointestinal tract during subsequent imaging.
• Step 3: Alternative Blood Sample Collection In some cases, a blood sample may be drawn instead. This sample is then centrifuged to separate the albumin, which is subsequently tagged with the isotope tracer. The tagged albumin is then injected back into the patient, serving the same purpose as the direct injection of dextran.
• Step 4: Imaging Procedure After a prescribed period, the patient is positioned on the imaging table with a gamma camera placed over the anterior abdomen and pelvis. This positioning is crucial for capturing accurate images of the gastrointestinal tract.
• Step 5: Scanning at Intervals Scanning is performed at specific intervals to monitor the distribution of the tracer. The physician observes for any visible exudation of the tracer in the gut, which indicates areas of protein loss.
• Step 6: Interpretation and Reporting Finally, the physician interprets the results of the gastrointestinal protein loss study and compiles a written report detailing the findings, which is essential for guiding further clinical management.

3. Post-Procedure

Post-procedure care for patients undergoing gastrointestinal protein loss imaging typically involves monitoring for any immediate adverse reactions to the tracer. Patients may be advised to hydrate adequately following the procedure to facilitate the elimination of the radiolabeled substances from their system. Additionally, the physician will review the findings from the imaging study with the patient, discussing any necessary follow-up actions or further diagnostic evaluations based on the results. It is important for patients to report any unusual symptoms or concerns following the procedure to their healthcare provider.