CPT® Code 78458

1. Indications

Venous thrombosis imaging (venogram) is indicated for the evaluation of suspected venous thromboembolism (VTE) and is performed under the following circumstances:

• Suspected Deep Vein Thrombosis (DVT) Patients presenting with symptoms such as swelling, pain, or tenderness in the extremities may require imaging to confirm or rule out the presence of a DVT.
• Post-Surgical Evaluation Individuals who have undergone surgical procedures, particularly those involving the lower extremities, may be assessed for venous thrombosis due to increased risk factors associated with surgery.
• Chronic Venous Insufficiency Patients with chronic venous insufficiency may undergo venography to evaluate the extent of venous obstruction or thrombosis contributing to their condition.
• Recurrent Thromboembolic Events Individuals with a history of recurrent thromboembolic events may require imaging to identify any underlying venous abnormalities or thrombosis.

2. Procedure

The venous thrombosis imaging procedure involves several critical steps to ensure accurate visualization of the venous system:

• Patient Preparation The patient is positioned comfortably on the imaging table, ensuring that the area of interest is accessible for imaging. An intravenous line is established to facilitate the administration of the radiolabeled isotope tracer.
• Injection of Radiolabeled Isotope A radiolabeled isotope tracer is injected directly into the patient's circulatory system through the established intravenous line. This tracer is essential for highlighting the blood vessels during imaging.
• Scanning Process After the injection, the gamma camera is positioned over the targeted area. Scanning is performed at specific intervals to allow the radiolabeled isotope to circulate and perfuse the veins. The timing of the scans is crucial to capture the dynamic flow of blood and any potential thrombus formation.
• Image Acquisition The gamma camera detects the emitted radioactive energy from the tracer and converts it into images. These images provide a visual representation of the venous system, allowing for the identification of any thrombosis present.
• Interpretation and Reporting Following the imaging, the physician interprets the acquired images and compiles a written report detailing the findings, which is essential for guiding further clinical management.

3. Post-Procedure

After the venous thrombosis imaging procedure, patients may be monitored for any immediate reactions to the radiolabeled tracer. It is generally expected that patients can resume normal activities shortly after the procedure, as there are typically no significant recovery requirements. However, patients should be advised to report any unusual symptoms, such as persistent pain or swelling in the injection site or extremities. The physician will review the imaging results and discuss the findings with the patient, including any necessary follow-up actions or treatments based on the results of the venogram.