How To Use CPT Code 78140

CPT 78140 describes a diagnostic nuclear medicine procedure known as labeled red cell sequestration, differential organ/tissue. This article will provide an overview of CPT 78140, including its official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 78140?

CPT 78140 is a diagnostic nuclear medicine procedure that involves studying the liver and spleen after injecting the patient with their own red blood cells, which have been tagged with a radiopharmaceutical. This procedure helps determine if the liver or spleen is the site of premature destruction of red cells.

2. Official Description

The official description of CPT code 78140 is: ‘Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic).’ This procedure involves the use of radiopharmaceuticals to study the liver and spleen and detect any abnormalities related to the sequestration of red blood cells.

3. Procedure

1. In this procedure, the healthcare provider withdraws a sample of the patient’s blood and separates the red blood cells.
2. The provider then tags the red blood cells with a radiopharmaceutical, such as chromium CR–51.
3. A portion of the tagged red blood cells is retained as a standard measure, while another equal portion is re-injected into the patient.
4. After the injection, the provider marks the location of the heart, spleen, and liver on the patient’s skin to ensure consistent measurements during subsequent scans.
5. After a 24-hour waiting period, the provider uses a probe or scintillation counter to detect and count the flashes of light produced by the radiopharmaceutical in the marked areas.
6. The provider compares various ratios and interprets the results to determine if the liver or spleen is responsible for the premature destruction of red cells.
7. The provider then dictates, reviews, and signs the nuclear medicine report based on their findings.

4. Qualifying circumstances

CPT 78140 is performed when there is a need to assess the differential organ/tissue involvement in the sequestration of red blood cells. This procedure is typically used to investigate conditions related to the liver and spleen, such as liver disease or splenic disorders. It is important to note that this procedure requires the use of radiopharmaceuticals and should only be performed by qualified healthcare professionals trained in nuclear medicine.

5. When to use CPT code 78140

CPT code 78140 should be used when there is a clinical suspicion of red cell sequestration in the liver and/or spleen. It is appropriate to bill this code when the provider performs the labeled red cell sequestration procedure to assess the differential involvement of these organs. However, it is important to review the specific documentation requirements and guidelines of the payer to ensure accurate reporting.

6. Documentation requirements

To support a claim for CPT 78140, the healthcare provider must document the following information:

• Clinical indication for the procedure
• Details of the radiopharmaceutical used
• Date and time of the procedure
• Specific measurements and ratios obtained during the procedure
• Interpretation of the results
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 78140, it is important to ensure that the procedure is performed by a qualified healthcare professional trained in nuclear medicine. The provider should follow the specific documentation requirements and guidelines of the payer to ensure accurate reporting. It is also important to consider the use of modifiers, such as modifier 26 for the professional component or modifier TC for the technical component, depending on the circumstances of the service.

8. Historical information

CPT 78140 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2008, with an updated description: ‘Labeled red cell sequestration, differential organ/tissue, (eg, splenic and/or hepatic).’ Since then, there have been no further updates or changes to the code.

9. Examples

1. A healthcare provider performs a labeled red cell sequestration procedure to assess the differential involvement of the liver and spleen in a patient with suspected liver disease.
2. A nuclear medicine specialist conducts a labeled red cell sequestration procedure to investigate the sequestration of red blood cells in the spleen of a patient with a suspected splenic disorder.
3. A radiologist performs a labeled red cell sequestration procedure to determine if the liver or spleen is responsible for the premature destruction of red cells in a patient with an unexplained anemia.
4. A hematologist orders a labeled red cell sequestration procedure to assess the differential organ/tissue involvement in a patient with a known red cell sequestration disorder.
5. A nuclear medicine technologist assists in a labeled red cell sequestration procedure to evaluate the differential involvement of the liver and spleen in a patient with a history of liver and spleen abnormalities.
6. A healthcare provider performs a labeled red cell sequestration procedure to investigate the differential organ/tissue involvement in a patient with suspected red cell sequestration due to an underlying hematological condition.
7. A radiology team conducts a labeled red cell sequestration procedure to assess the differential involvement of the liver and spleen in a patient with a suspected autoimmune disorder.