© Copyright 2025 American Medical Association. All rights reserved.
Cerebrospinal fluid (CSF) flow imaging is a diagnostic procedure that utilizes scintigraphy along with a radiolabeled isotope tracer to assess the functionality and patency of shunts placed in the brain. These shunts are critical medical devices used to manage conditions where there is an obstruction in the normal flow of CSF, which can lead to increased intracranial pressure and other complications. The procedure involves the injection of a radiolabeled tracer into the CSF through a reservoir associated with the shunt. This allows for the visualization of CSF movement and helps determine whether the shunt is functioning properly. The imaging is conducted with the patient positioned on an imaging table, where a gamma camera captures the emitted radioactive energy at predetermined intervals, creating detailed images of the CSF flow. The results of this imaging study are then interpreted by a physician, who compiles a comprehensive report detailing the findings, which is essential for guiding further clinical management of the patient.
© Copyright 2025 Coding Ahead. All rights reserved.
The cerebrospinal fluid flow imaging procedure is indicated for the evaluation of shunt patency in patients who have undergone shunt placement for the management of conditions affecting CSF flow. The following conditions may warrant this imaging study:
The procedure for cerebrospinal fluid flow imaging involves several key steps to ensure accurate assessment of shunt function:
After the cerebrospinal fluid flow imaging procedure, patients may be monitored for any immediate adverse effects related to the injection of the radiolabeled tracer. Typically, there are no significant post-procedure complications, and patients can resume normal activities unless otherwise advised by their physician. The results of the imaging study will be discussed with the patient during a follow-up appointment, where the physician will outline any necessary further actions based on the findings of the report.
| Short Descr | CSF SHUNT EVALUATION | Medium Descr | CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ | Long Descr | Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation | 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 | 209 - Radioisotope scan and function studies |
| 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 | 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 | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | 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 | 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 |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.