2025 CPT code 78291

Peritoneal-venous shunt patency test (e.g., for LeVeen, Denver shunt).

Follow CPT guidelines for radiology and nuclear medicine procedures.Proper documentation of the procedure and findings is crucial for accurate coding and reimbursement.

Modifiers 26 (professional component) and TC (technical component) may be applicable, depending on the services rendered.Consult payer-specific guidelines.

Medical necessity is established when a patient presents with clinical findings suggestive of peritoneal-venous shunt malfunction (e.g., recurrent ascites, abdominal distension) and the test is required to assess the shunt's patency and guide management decisions.

The clinical responsibility involves injecting the radioactive tracer, performing the gamma camera scan, interpreting the resulting images to assess shunt patency, and documenting the findings.A physician specializing in nuclear medicine or radiology typically performs this procedure.

IMPORTANT For the injection procedure, use code 49427.Modifier 26 (professional component) should be appended if only physician interpretation is reported; modifier TC (technical component) should be appended if only the technical component is reported.Payer policies may vary regarding modifier TC for hospitals.Do not append professional or technical modifiers when reporting a global service.

In simple words: This test checks if a tube (shunt) that drains fluid from your belly is working correctly. A special substance is injected, and a scanner makes pictures to see if the substance is moving through the tube as it should.

This procedure involves evaluating the patency and function of a peritoneal-venous shunt (e.g., LeVeen, Denver shunt). A radioactive tracer is injected into the peritoneal cavity, and the abdomen and chest are scanned using a gamma camera to assess tracer distribution.The images are evaluated to determine if the tracer is being appropriately absorbed by lung and liver cells, indicating proper fluid movement back to the systemic circulation.The procedure does not include the supply of the radiopharmaceutical.

Example 1: A patient with ascites due to liver cirrhosis has a LeVeen shunt.This test is performed to assess shunt function and identify any potential blockages affecting fluid drainage., A patient with recurrent ascites after placement of a Denver shunt undergoes this test to evaluate the shunt's patency and troubleshoot persistent fluid buildup., Post-operative evaluation of a peritoneal venous shunt is indicated to identify early complications or malfunction.This nuclear medicine scan provides a non-invasive assessment.

** The radiopharmaceutical is not included in this code. Use appropriate supply codes to bill for the radiopharmaceutical separately.The interpretation of the scan may be billed separately if the technical component is also billed.

  • Revenue Code: I1E (STANDARD IMAGING - NUCLEAR MEDICINE)
  • RVU: Not available in provided data.RVUs vary based on geographic location and other factors.
  • Global Days : Not specified in the provided data.The global period would depend on payer policies and may vary.
  • Payment Status: Active
  • Modifier TC rule: Modifier TC (technical component) applies if only the technical aspect of the procedure (imaging) is reported separately.
  • Fee Schedule : Not available in provided data.Fee schedules vary based on location and payer.
  • Specialties:Nuclear Medicine, Radiology, Gastroenterology
  • Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center
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