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Brain imaging, as described by CPT® Code 78600, involves the use of scintigraphy and a radiolabeled isotope tracer to capture static images of the brain. This imaging technique is particularly significant in the assessment of brain death, providing critical information regarding the brain's functionality. During the procedure, the patient is carefully positioned on an imaging table, and a gamma camera is aligned to focus on the entire head and neck region. An intravenous line is established to facilitate the injection of the radiolabeled isotope tracer directly into the patient's circulatory system. This tracer allows for the visualization of brain activity and blood flow. In cases where vascular flow imaging is included, the imaging process commences as soon as the isotope bolus reaches the neck and continues through the venous phase. A scintillation detector is employed to capture the spatial distribution of the radiopharmaceutical within the brain. The imaging captures views from anterior, right lateral, and left lateral positions, with static images taken at a single point in time for approximately five minutes for each of the three view positions. The procedure may also involve zoning and magnification of specific areas of interest to enhance diagnostic accuracy. Following the imaging, the physician interprets the results and generates a written report detailing the findings. It is important to note that CPT® Code 78600 is specifically designated for brain imaging that includes less than four static views, while CPT® Code 78601 is applicable when vascular flow studies are performed alongside the static views.
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The procedure associated with CPT® Code 78600 is indicated for various clinical scenarios, primarily focusing on the assessment of brain function and the determination of brain death. The following conditions may warrant the use of this imaging technique:
The procedure for brain imaging using CPT® Code 78600 involves several critical steps that ensure accurate imaging and assessment of the brain. The following outlines the procedural steps:
Post-procedure care following the brain imaging with CPT® Code 78600 typically involves monitoring the patient for any immediate reactions to the radiolabeled isotope tracer. Patients may be advised to hydrate adequately to facilitate the elimination of the tracer from their system. Additionally, the physician will review the imaging results and discuss the findings with the patient or their family, providing necessary follow-up recommendations based on the interpretation of the images. It is important for the healthcare team to ensure that the patient understands the results and any further steps that may be required in their care.
| Short Descr | BRAIN IMAGE < 4 VIEWS | Medium Descr | BRAIN IMAGING <4 STATIC VIEWS | Long Descr | Brain imaging, less than 4 static views; | 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) | 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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | 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 | 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 | 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 | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | 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 | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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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| 2010-01-01 | Changed | Code description changed. |
| 2008-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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