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The CPT® Code 78291 refers to a diagnostic procedure known as the peritoneal-venous shunt patency test, which is specifically utilized for assessing the functionality of shunts such as the LeVeen or Denver shunt. This test is crucial for determining whether the shunt is patent, meaning it is open and functioning as intended. The procedure involves the use of imaging technology that is strategically placed over the patient's abdomen and thorax, allowing healthcare professionals to visualize the pump and shunt tubing effectively. A radiotracer, typically a radioactive substance like TC99m-SC or TC99m-MAA, is injected separately to facilitate this visualization. In the case of a LeVeen shunt, the abdomen is gently massaged to ensure even distribution of the radiotracer, while for a Denver shunt, the patient is instructed to actively pump the system to aid in the process. Following the injection of the radiotracer, an initial anterior abdominal image is captured immediately, followed by a series of images taken every 15 minutes for up to one hour. The expected outcome of a patent shunt is the visualization of the radionuclide in the lungs and/or liver within this timeframe. If no such visualization occurs within the first hour, additional delayed imaging may be performed 2 to 4 hours post-injection. Should there still be no visualization after 4 hours, it indicates that the shunt is obstructed. The entire procedure is supervised by a physician, who is responsible for interpreting the results and providing a written report of the findings.
© Copyright 2025 Coding Ahead. All rights reserved.
The peritoneal-venous shunt patency test is indicated for patients who have undergone the placement of a peritoneal-venous shunt, such as the LeVeen or Denver shunt. This test is performed to evaluate the patency of the shunt, which is essential for ensuring proper fluid drainage from the peritoneal cavity into the venous system. The indications for this procedure may include:
The procedure for the peritoneal-venous shunt patency test involves several key steps that are critical for accurate assessment. These steps include:
After the completion of the peritoneal-venous shunt patency test, the patient may be monitored for any immediate reactions to the radiotracer. There are typically no specific post-procedure care requirements, but patients should be informed about the potential for delayed imaging if initial results are inconclusive. The physician will review the images obtained and provide a written report detailing the findings, which will guide further management of the patient's condition based on the shunt's status.
| Short Descr | LEVEEN/SHUNT PATENCY EXAM | Medium Descr | PERITONEAL-VENOUS SHUNT PATENCY TEST | Long Descr | Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) | 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 | 1 | CCS Clinical Classification | 209 - Radioisotope scan and function studies |
| 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. | 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). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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 | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | RT | Right side (used to identify procedures performed on the right side of the body) | 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 |
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| Pre-1990 | Added | Code added. |