CPT® Code 78585

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1. Indications

The pulmonary perfusion imaging procedure, coded as CPT® 78585, is indicated for various clinical scenarios where assessment of lung blood flow and ventilation is necessary. The following conditions may warrant this imaging study:

• Assessment of Pulmonary Embolism This procedure is often utilized to evaluate patients suspected of having a pulmonary embolism, a condition where blood flow to the lungs is obstructed by a blood clot.
• Evaluation of Lung Function It is indicated for patients with unexplained respiratory symptoms or those with known lung diseases to assess the adequacy of blood flow and ventilation in the lungs.
• Preoperative Assessment This imaging may be performed as part of the preoperative evaluation for patients undergoing lung surgery to ensure that the lung regions are functioning properly.
• Monitoring of Lung Disease Progression It can be used to monitor the progression of chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) or interstitial lung disease, by providing insights into changes in lung perfusion and ventilation over time.

2. Procedure

The pulmonary perfusion imaging procedure involves several key steps that are essential for obtaining accurate diagnostic information. The following outlines the procedural steps involved:

• Step 1: Patient Preparation Prior to the procedure, the patient is prepared by explaining the process and ensuring they understand the importance of following instructions, such as holding their breath during specific phases of the imaging.
• Step 2: Injection of Radioactive Particles The physician administers a dose of radioactive particles intravenously. These particles are specifically designed to be too large to pass through the capillaries, allowing for the visualization of blood flow in the lungs.
• Step 3: Imaging with a Special Camera A specialized gamma camera is used to capture images of the lungs as the radioactive particles accumulate. The camera detects the emitted radiation from the particles, creating a visual representation of blood flow patterns within the lung tissue.
• Step 4: Ventilation Assessment Following the perfusion imaging, the patient inhales radioactive Xenon gas. The patient is instructed to hold their breath for as long as possible, allowing the gas to distribute throughout the lung tissue. This step is crucial for assessing areas of the lungs that may not be adequately ventilated.
• Step 5: Washout Imaging After the inhalation phase, the patient exhales, and an image is taken to observe any particles that may be trapped in the airways. This imaging helps identify potential airway obstructions that could affect lung function.

3. Post-Procedure

After the completion of the pulmonary perfusion imaging procedure, patients are typically monitored for a short period to ensure there are no immediate adverse reactions to the radioactive materials used. Patients may be advised to drink plenty of fluids to help flush the radioactive particles from their system. It is important to inform patients that the radiation exposure from this procedure is minimal and generally considered safe. They may resume normal activities unless otherwise directed by their physician. Follow-up appointments may be scheduled to discuss the results of the imaging and any further diagnostic or therapeutic steps that may be necessary based on the findings.