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Venous thrombosis imaging, commonly referred to as a venogram, is a diagnostic procedure utilized to visualize the veins in a specific area of the body to detect the presence of blood clots. This imaging technique employs scintigraphy, which involves the use of a radiolabeled isotope tracer that is injected into the patient's circulatory system. The procedure is particularly important in identifying venous thrombosis, a condition that can arise due to various factors such as local injury to blood vessels, venous stasis (a condition where blood flow is sluggish), turbulence in blood flow, or changes in the blood's coagulation properties, known as hypercoagulopathy. During the procedure, the patient is carefully positioned on an imaging table, and a gamma camera is placed over the targeted area to be examined. An intravenous line is established to facilitate the injection of the radiolabeled isotope tracer, which allows for the visualization of blood flow within the veins. After the tracer is administered, scanning occurs at predetermined intervals to capture images as the radioisotope circulates and perfuses the designated body region. The emitted radioactive energy is then converted into detailed images that can be analyzed for the presence of thrombosis. CPT® Code 78457 specifically designates this procedure when it is performed unilaterally, meaning it focuses on one side of the body. In contrast, CPT® Code 78458 is used for bilateral venograms, which assess both sides. Following the imaging, the physician interprets the results and generates a comprehensive written report detailing the findings of the study.
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Venous thrombosis imaging (venogram) is indicated for the evaluation of various conditions and symptoms that may suggest the presence of blood clots in the venous system. The following are the explicitly provided indications for performing this procedure:
The venous thrombosis imaging procedure involves several critical steps to ensure accurate visualization of the venous system. The following outlines the procedural steps as described:
After the venous thrombosis imaging procedure, patients may be monitored briefly to ensure there are no immediate adverse reactions to the radiolabeled tracer. It is generally expected that patients can resume normal activities shortly after the procedure, as there are no significant recovery requirements associated with this imaging technique. However, patients may be advised to follow up with their healthcare provider to discuss the results of the imaging study and any necessary further evaluations or treatments based on the findings. Additionally, any specific post-procedure instructions provided by the physician should be followed to ensure optimal care and management.
| Short Descr | VENOUS THROMBOSIS IMAGING | Medium Descr | VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL | Long Descr | Venous thrombosis imaging, venogram; unilateral | 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 | 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. | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | 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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| Pre-1990 | Added | Code added. |
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