How To Use CPT Code 78191

CPT 78191 describes a diagnostic nuclear medicine procedure that involves studying the lifespan of platelets in a patient’s blood. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78191?

CPT 78191 is used to describe a diagnostic nuclear medicine procedure that focuses on studying the lifespan of platelets in a patient’s blood. This procedure involves drawing a blood sample from the patient and tagging the platelets with a radiopharmaceutical. The tagged platelets are then re-transfused back into the patient. The provider collects blood samples at various intervals to determine the survival time of the platelets. This procedure helps diagnose and monitor conditions such as thrombocytopenia, aplastic anemia, leukemia, and other diseases related to platelet function.

2. Official Description

The official description of CPT code 78191 is: ‘The provider studies platelet lifespan after drawing a sample of the patient’s blood, tagging the platelets with a radiopharmaceutical, and then re-transfusing them into the patient.’

3. Procedure

1. The provider begins by drawing a blood sample from the patient.
2. The platelets in the blood sample are tagged with a radiopharmaceutical, such as Indium In 111 oxyquinoline.
3. The tagged platelets are then re-transfused back into the patient.
4. The provider collects blood samples at specific intervals, typically starting at 20 minutes after the tagged platelets are injected.
5. Additional blood samples are taken at 2 hours, 3 hours, and 4 hours after the injection, and then daily for up to 10 days or until the radioactivity level reduces to 10 percent of the maximum activity.
6. If the provider expects the platelet survival to be short, additional samples may be taken on the first day.
7. The provider interprets the results of the study and prepares a nuclear medicine report.

4. Qualifying circumstances

CPT 78191 is performed when there is a need to study the lifespan of platelets in a patient’s blood. This procedure is typically used to diagnose and monitor conditions such as thrombocytopenia, aplastic anemia, leukemia, and other diseases related to platelet function. The provider must have the necessary expertise in nuclear medicine to perform this procedure.

5. When to use CPT code 78191

CPT code 78191 should be used when a provider performs a diagnostic nuclear medicine procedure to study the lifespan of platelets in a patient’s blood. This code is appropriate when the provider draws a blood sample, tags the platelets with a radiopharmaceutical, and re-transfuses them back into the patient. The procedure helps diagnose and monitor various platelet-related conditions. It is important to note that CPT code 78191 should not be used for other nuclear medicine procedures that do not involve platelet lifespan studies.

6. Documentation requirements

To support a claim for CPT code 78191, the provider must document the following information:

• Patient’s medical history and reason for the platelet lifespan study
• Details of the radiopharmaceutical used to tag the platelets
• Date and time of the blood sample collection and re-transfusion
• Timing and frequency of the blood samples collected after the injection
• Interpretation of the study results
• Signature of the provider who performed the procedure

7. Billing guidelines

When billing for CPT code 78191, it is important to ensure that the procedure meets the criteria outlined in the official description. The provider should append the appropriate modifiers (e.g., modifier 26 for professional component or modifier TC for technical component) if only reporting a specific component of the procedure. It is also important to follow payer policies regarding the use of modifiers. CPT code 78191 should not be reported with other codes unless there are specific circumstances that warrant their use.

8. Historical information

CPT code 78191 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 patient with suspected thrombocytopenia undergoes a platelet lifespan study to determine the cause of their low platelet count.
2. A patient with aplastic anemia undergoes a platelet lifespan study to assess the production and survival of platelets in their blood.
3. A patient with leukemia undergoes a platelet lifespan study to monitor the effectiveness of their treatment and assess any abnormalities in platelet function.
4. A patient with a suspected platelet disorder undergoes a platelet lifespan study to evaluate the function and lifespan of their platelets.
5. A patient with a history of excessive bleeding undergoes a platelet lifespan study to investigate any underlying platelet abnormalities.
6. A patient with a suspected immune-mediated platelet disorder undergoes a platelet lifespan study to assess platelet destruction and survival.
7. A patient with a suspected platelet pooling disorder undergoes a platelet lifespan study to evaluate platelet distribution and survival in their blood vessels.
8. A patient with a suspected platelet disorder undergoes a platelet lifespan study to assess platelet production and survival in their bone marrow.
9. A patient with a suspected platelet disorder undergoes a platelet lifespan study to evaluate platelet function and survival in response to various stimuli.
10. A patient with a suspected platelet disorder undergoes a platelet lifespan study to assess platelet clearance and survival in their spleen and liver.