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The procedure represented by CPT® Code 78709 involves a comprehensive assessment of the kidneys' morphology, vascular flow, and function through advanced imaging techniques. This evaluation is crucial for understanding the size, shape, and structural integrity of the kidneys, as well as their ability to perform essential functions such as filtering waste from the bloodstream, maintaining chemical balance, and producing hormones like erythropoietin, renin, and calcitriol. The imaging is conducted using scintigraphy, which employs a radiolabeled isotope tracer to visualize kidney activity. This method allows healthcare professionals to assess various renal conditions, including renovascular hypertension, renal cysts, tumors, abscesses, and overall kidney disease. Additionally, it plays a vital role in monitoring kidney transplants. During the procedure, an intravenous line is established to facilitate the injection of the radiolabeled tracer directly into the patient's circulatory system. The patient is then positioned on an imaging table, where a gamma camera captures images of the kidneys at specific intervals, converting the emitted radioactive energy into detailed images. The use of pharmacological interventions, such as diuretics and angiotensin-converting enzyme (ACE) inhibitors, may enhance the imaging process by providing clearer insights into kidney obstruction and hypertension related to renal vascular flow. This multifaceted approach ensures a thorough evaluation of kidney health, with the physician interpreting the results and generating a comprehensive written report of the findings.
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The procedure represented by CPT® Code 78709 is indicated for a variety of renal conditions and assessments. The following are the specific indications for which this imaging study may be performed:
The procedure for CPT® Code 78709 involves several critical steps to ensure accurate imaging and assessment of kidney morphology, vascular flow, and function. The following outlines the procedural steps:
Post-procedure care for patients undergoing CPT® Code 78709 typically involves monitoring for any immediate reactions to the radiolabeled tracer or pharmacological interventions administered during the study. Patients may be advised to hydrate adequately to help flush the tracer from their system. Additionally, the physician will review the findings from the imaging study and discuss any necessary follow-up actions or treatments based on the results. It is important for patients to understand the significance of the findings and any further evaluations or interventions that may be required to address their renal health.
| Short Descr | K FLOW/FUNCT IMAGE MULTIPLE | Medium Descr | KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE | Long Descr | Kidney imaging morphology; with vascular flow and function, multiple studies, with and without 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 | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | ME | The order for this service adheres to appropriate use criteria in the 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | 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). | 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. | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | LT | Left side (used to identify procedures performed on the left side of the body) | 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 | 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 | 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 | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional |
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| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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