How To Use CPT Code 78122

CPT 78122 describes the procedure for determining the patient’s whole blood volume, including separate measurements of plasma volume and red cell volume using a radiopharmaceutical volume-dilution technique. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78122?

CPT 78122 can be used to describe the procedure performed by a provider to measure the patient’s whole blood volume, including the volumes of plasma and red blood cells. This procedure involves injecting the patient with a radiopharmaceutical and tagged red blood cells, and then calculating the volumes using an isotope dilution principle.

2. Official Description

The official description of CPT code 78122 is: ‘Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique).’ There are no additional notes available for this code.

3. Procedure

1. The provider begins by removing a sample of the patient’s blood.
2. A portion of the blood sample is kept as a patient blank, another portion is used to prepare the standard, and the remaining portion is tagged with a radiopharmaceutical.
3. Two identical doses of the tagged red blood cells and a protein tracer are prepared.
4. The patient is injected with both radiopharmaceuticals through the same intravenous line.
5. After waiting for the labeled blood to circulate, the provider collects three samples in 10-minute intervals.
6. The hematocrit of the samples is determined, and the radioactivity of equal portions of the patient’s whole blood, the standard vials, and the patient blank is compared using a scintillation counter.
7. The provider then calculates the total blood, red cell, and plasma volumes based on the concentration of the tracer substances.
8. The findings are reviewed with the referring physician, and a nuclear medicine report is dictated, reviewed, and signed by the provider.

4. Qualifying circumstances

CPT 78122 is performed when there is a need to measure the patient’s whole blood volume, including separate measurements of plasma volume and red cell volume. This procedure is typically used to diagnose conditions such as an increase in red blood cell mass, total blood volume, or white blood cell count above the normal range. It can also be used to assess cases where the body produces too many blood platelets. The procedure requires the use of a radiopharmaceutical volume-dilution technique.

5. When to use CPT code 78122

CPT code 78122 should be used when the provider needs to determine the patient’s whole blood volume, including separate measurements of plasma volume and red cell volume. It is appropriate to use this code when performing the specific procedure described in the official description. However, it should not be used for other types of blood volume measurements or procedures.

6. Documentation requirements

To support a claim for CPT 78122, the provider must document the following information:

• Reason for performing the procedure and the need to measure the patient’s whole blood volume
• Details of the radiopharmaceutical volume-dilution technique used
• Date and time of the procedure
• Results of the measurements, including the total blood, red cell, and plasma volumes
• Review of the findings with the referring physician
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 78122, ensure that the procedure is performed according to the official description and documentation requirements. It is important to use the correct CPT code for the specific procedure performed. There are no specific guidelines regarding reporting CPT code 78122 with other codes. However, it is important to follow payer policies and guidelines for accurate billing.

8. Historical information

CPT 78122 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs CPT 78122 to determine the whole blood volume, plasma volume, and red cell volume of a patient with polycythemia.
2. Using CPT 78122, a provider measures the whole blood volume, plasma volume, and red cell volume of a patient with thrombocytosis.
3. CPT 78122 is used by a provider to assess the whole blood volume, plasma volume, and red cell volume of a patient with leukocytosis.
4. A provider performs CPT 78122 to determine the whole blood volume, plasma volume, and red cell volume of a patient with anemia.
5. Using CPT 78122, a provider measures the whole blood volume, plasma volume, and red cell volume of a patient with a suspected blood disorder.
6. CPT 78122 is used by a provider to assess the whole blood volume, plasma volume, and red cell volume of a patient with abnormal blood test results.
7. A provider performs CPT 78122 to determine the whole blood volume, plasma volume, and red cell volume of a patient with a history of blood clots.
8. Using CPT 78122, a provider measures the whole blood volume, plasma volume, and red cell volume of a patient with a known blood disorder.