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Official Description

Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 78708 involves kidney imaging that assesses the morphology, vascular flow, and function of the kidneys through a single study. This imaging is performed using scintigraphy, which utilizes a radiolabeled isotope tracer to visualize the kidneys. The kidneys play a crucial role in filtering waste from the bloodstream, maintaining chemical balance, and producing essential hormones such as erythropoietin, renin, and calcitriol. Erythropoietin is vital for red blood cell production, renin is involved in blood pressure regulation, and calcitriol aids in calcium absorption in the bones. The imaging procedure is particularly useful for evaluating various renal conditions, including renal blood flow issues, renovascular hypertension, renal cysts, tumors, abscesses, and kidney diseases. It is also employed to monitor kidney transplant function. During the procedure, an intravenous line is established to inject the radiolabeled isotope tracer directly into the patient's circulatory system. The patient is then positioned on an imaging table, and a gamma camera is focused on the kidneys to capture images. Scanning occurs at specific intervals, and the emitted radioactive energy is converted into detailed images of the kidneys. Additionally, pharmacological interventions such as diuretics may be administered to enhance image clarity, particularly in cases of kidney obstruction. An angiotensin converting enzyme (ACE-inhibitor) may also be given to assess the relationship between hypertension and renal vascular flow. This code is specifically designated for studies that include these pharmacological interventions, distinguishing it from other related codes that may not involve such medications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 78708 is indicated for various renal conditions and assessments, including:

  • Renal Blood Flow Evaluation This procedure is performed to assess the blood flow to the kidneys, which is crucial for understanding renal function and diagnosing potential vascular issues.
  • Renovascular Hypertension It is utilized to evaluate hypertension that may be related to renal vascular abnormalities, helping to determine the underlying causes of high blood pressure.
  • Assessment of Renal Cysts The imaging can help identify and characterize renal cysts, which may require further evaluation or monitoring.
  • Detection of Tumors This procedure aids in the identification of renal tumors, providing critical information for diagnosis and treatment planning.
  • Identification of Abscesses It is used to detect renal abscesses, which are localized infections that can affect kidney function.
  • Evaluation of Kidney Disease The procedure is beneficial in assessing various forms of kidney disease, providing insights into the extent and nature of the condition.
  • Monitoring Kidney Transplants It is also indicated for monitoring the function of kidney transplants, ensuring that the transplanted organ is functioning properly.

2. Procedure

The procedure for CPT® Code 78708 involves several key steps that ensure accurate imaging of the kidneys:

  • Establishment of Intravenous Access An intravenous line is established to facilitate the administration of the radiolabeled isotope tracer directly into the patient's circulatory system. This step is crucial for ensuring that the tracer reaches the kidneys effectively.
  • Injection of Radiolabeled Isotope Tracer The radiolabeled isotope tracer is injected through the intravenous line. This tracer is essential for visualizing the kidneys during the imaging process, as it emits radioactive energy that can be detected by the gamma camera.
  • Patient Positioning The patient is positioned on the imaging table, ensuring that the gamma camera is appropriately focused on the kidneys. Proper positioning is vital for obtaining clear and accurate images.
  • Scanning Process Scanning is performed at specific intervals, during which the gamma camera captures images of the kidneys. The emitted radioactive energy from the tracer is converted into detailed images, allowing for assessment of kidney morphology, vascular flow, and function.
  • Administration of Pharmacological Interventions During the procedure, a diuretic may be administered to enhance the clarity of images, particularly in cases where kidney obstruction is suspected. Additionally, an angiotensin converting enzyme (ACE-inhibitor) may be given to evaluate the relationship between hypertension and renal vascular flow.
  • Interpretation and Reporting After the imaging is complete, the physician interprets the study results and provides a written report detailing the findings. This report is essential for guiding further clinical decision-making and management.

3. Post-Procedure

Post-procedure care for patients undergoing the imaging study associated with CPT® Code 78708 typically involves monitoring for any immediate reactions to the administered medications, particularly the diuretics and ACE-inhibitors. Patients may be advised to hydrate adequately to help flush the radiolabeled tracer from their system. The physician will review the findings from the imaging study and discuss any necessary follow-up actions or additional testing that may be required based on the results. It is important for patients to understand the significance of the findings and any implications for their renal health moving forward.

Short Descr K FLOW/FUNCT IMAGE W/DRUG
Medium Descr KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX
Long Descr Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)
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
GC This service has been performed in part by a resident under the direction of a teaching physician
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
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
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
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
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
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.
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
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.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
FS Split (or shared) evaluation and management visit
FY X-ray taken using computed radiography technology/cassette-based imaging
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
LT Left side (used to identify procedures performed on the left side of the body)
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
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
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
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
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
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
2007-01-01 Changed Code description changed.
1998-01-01 Added First appearance in code book in 1998.
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