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The CPT® Code 78582 refers to a specific type of pulmonary nuclear imaging study that evaluates lung function through a two-phase process involving both ventilation and perfusion imaging. In this context, ventilation pertains to the ability of air to reach all areas of the lungs, while perfusion relates to the circulation of blood within the lung tissue. This dual assessment is crucial for diagnosing various pulmonary conditions. The procedure utilizes radioactive tracers that are introduced into the body to visualize lung structures and blood flow. During the ventilation phase, a gaseous radionuclide, such as xenon or technetium DTPA, is inhaled by the patient, allowing for the assessment of air distribution in the lungs. In the perfusion phase, a radioactive tracer, typically technetium macro aggregated albumin (Tc99m-MAA), is injected intravenously to evaluate blood flow through the lung vasculature. The combination of these two imaging techniques provides comprehensive insights into lung function, enabling healthcare professionals to identify abnormalities and make informed clinical decisions. Throughout the procedure, the patient is closely monitored, and the physician reviews the obtained images to generate a detailed written report of the findings, ensuring that all relevant data is captured for further analysis and treatment planning.
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The pulmonary ventilation and perfusion imaging study, represented by CPT® Code 78582, is indicated for various clinical scenarios where assessment of lung function is necessary. The following conditions may warrant this procedure:
The procedure for CPT® Code 78582 involves a systematic approach to conducting a two-phase ventilation and perfusion study. The following steps outline the detailed process:
After the completion of the pulmonary ventilation and perfusion imaging study, the patient may be observed for a short period to ensure there are no immediate adverse reactions to the radioactive tracers used during the procedure. Generally, patients can resume normal activities shortly after the study, as the amount of radiation exposure is minimal and considered safe. However, specific post-procedure instructions may be provided by the healthcare team, including hydration recommendations to help flush the radioactive material from the body. The physician will discuss the results of the imaging study with the patient during a follow-up appointment, where further management or treatment options may be considered based on the findings.
| Short Descr | LUNG VENTILAT&PERFUS IMAGING | Medium Descr | PULMONARY VENTILATION & PERFUSION IMAGING | Long Descr | Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging | 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) | I4B - Imaging/procedure - other | MUE | 1 | CCS Clinical Classification | 208 - Radioisotope pulmonary 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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | ME | The order for this service adheres to appropriate use criteria in the 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 | 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 | MF | The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | CR | Catastrophe/disaster related | GW | Service not related to the hospice patient's terminal condition | 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 | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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). | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AM | Physician, team member service | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | MB | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access | MC | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q3 | Live kidney donor surgery and related services | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2012-01-01 | Added | Added |
| 1993-12-31 | Deleted | Code deleted. |
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