© Copyright 2025 American Medical Association. All rights reserved.
Cardiac shunt detection is a diagnostic procedure that utilizes scintigraphy along with a radiolabeled isotope tracer to assess abnormal blood flow within the heart. This procedure is essential for identifying deviations from the normal circulatory pathways, which can indicate the presence of congenital heart defects. In cases of left to right shunting, which is commonly associated with conditions such as septal defects and persistent ductus arteriosus, oxygen-rich blood from the systemic circulation leaks back into the pulmonary circulation. This abnormal flow can lead to increased blood volume in the lungs and potential complications if left untreated. Conversely, right to left shunting occurs in conditions like pulmonary atresia, tricuspid valve atresia, and tetralogy of Fallot, where oxygen-poor blood is shunted from the right side of the heart to the left, entering systemic circulation and resulting in cyanosis and hypoxemia. During the procedure, the patient is positioned on an imaging table, and a gamma camera is placed over the anterior chest to capture the distribution of the radiolabeled tracer. An intravenous line is established to administer the tracer directly into the bloodstream. Scanning is conducted at predetermined intervals, and the emitted radioactive energy is processed as a cine loop on a computer, allowing for real-time visualization of blood flow. The interpretation of the results is performed by a physician, who will provide a comprehensive written report detailing the findings of the study.
© Copyright 2025 Coding Ahead. All rights reserved.
The cardiac shunt detection procedure is indicated for the evaluation of various congenital heart defects and abnormal blood flow patterns. The following conditions may warrant this diagnostic study:
The cardiac shunt detection procedure involves several critical steps to ensure accurate assessment of blood flow within the heart. The following procedural steps are performed:
After the cardiac shunt detection procedure, the patient may be monitored for any immediate reactions to the radiolabeled tracer. There are typically no specific post-procedure care requirements, but patients may be advised to hydrate adequately to help flush the tracer from their system. The physician will provide a written report detailing the findings of the study, which will be used for further clinical decision-making regarding the patient's condition.
| Short Descr | CARDIAC SHUNT IMAGING | Medium Descr | CARDIAC SHUNT DETECTION | Long Descr | Cardiac shunt detection | 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) | 6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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). | 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. | 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 | 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 | 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. |