How To Use CPT Code 78291

CPT 78291 describes the peritoneal-venous shunt patency test, which is used to evaluate the functionality of a peritoneal-venous shunt. 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 78291?

CPT 78291 is a code used to describe the peritoneal-venous shunt patency test. This test is performed by a healthcare provider to ensure that the peritoneal-venous shunt is not blocked and is functioning properly. It is a noninvasive nuclear medicine test that involves injecting a radioactive tracer into the peritoneal cavity and using a gamma camera to scan the abdomen and chest. The provider then evaluates the resulting images to determine if the shunt is working correctly.

2. Official Description

The official description of CPT code 78291 is: ‘Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt).’ This code is used specifically for the evaluation of the peritoneal-venous shunt to ensure its patency and proper functioning. It is important to note that for the injection procedure, a different code, 49427, should be used.

3. Procedure

1. In the peritoneal-venous shunt patency test, the healthcare provider injects a radioactive tracer into the peritoneal cavity.
2. Using a gamma camera, the provider then scans the abdomen and chest to capture images of the tracer distribution throughout the peritoneal cavity.
3. The resulting images are evaluated by the provider to determine if the tracer has been taken up by the lung and liver cells, indicating proper functioning of the shunt.

4. Qualifying circumstances

The peritoneal-venous shunt patency test is typically performed on patients who have a peritoneal-venous shunt, also known as a LeVeen shunt. This device is used to remove excess ascetic fluid from the abdominal cavity to the venous system. The test is used to ensure that the shunt is not blocked and is functioning properly. It is important to note that the test is noninvasive and does not involve any surgical procedures.

5. When to use CPT code 78291

CPT code 78291 should be used when a healthcare provider performs a peritoneal-venous shunt patency test to evaluate the functionality of the shunt. It is important to ensure that the test is performed specifically for the evaluation of the peritoneal-venous shunt and not for any other purpose.

6. Documentation requirements

To support a claim for CPT code 78291, the healthcare provider must document the following information:

• Patient’s medical history and indication for the peritoneal-venous shunt patency test
• Details of the radioactive tracer used
• Date and time of the test
• Interpretation of the images and findings
• Signature of the healthcare provider performing the test

7. Billing guidelines

When billing for CPT code 78291, it is important to ensure that the test is performed specifically for the evaluation of the peritoneal-venous shunt. The provider who performs the injection part of the procedure should report that service using the appropriate code, 49427. If reporting only the physician’s interpretation for the radiology service, modifier 26 should be appended to the radiology code. If reporting only the technical component, modifier TC should be appended to the radiology code. However, it is important to note that payer policies may exempt hospitals from appending modifier TC. It is also important to consider the location of the testing, as it may affect how the test is coded.

8. Historical information

CPT code 78291 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 a peritoneal-venous shunt undergoes a peritoneal-venous shunt patency test to evaluate the functionality of the shunt.
2. A healthcare provider performs a peritoneal-venous shunt patency test on a patient who has been experiencing symptoms of ascites to determine if the shunt is functioning properly.
3. A patient with a LeVeen shunt undergoes a peritoneal-venous shunt patency test to ensure that the shunt is not blocked and is functioning well.
4. A healthcare provider performs a peritoneal-venous shunt patency test on a patient who has recently had a peritoneal-venous shunt placed to evaluate the success of the procedure.
5. A patient with a Denver shunt undergoes a peritoneal-venous shunt patency test to assess the functionality of the shunt.
6. A healthcare provider performs a peritoneal-venous shunt patency test on a patient with a history of ascites to determine if the shunt is effectively removing excess fluid from the abdominal cavity.
7. A patient with a LeVeen shunt undergoes a peritoneal-venous shunt patency test to ensure that the shunt is not obstructed and is functioning optimally.
8. A healthcare provider performs a peritoneal-venous shunt patency test on a patient who has been experiencing complications related to their peritoneal-venous shunt to identify any issues with the shunt.