CPT® Code 0859T

Official Description

Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (List separately in addition to code for primary procedure)

Common Language Description

Noncontact near-infrared spectroscopy (NIRS) is a sophisticated imaging technique utilized primarily for the assessment of wounds, including diabetic ulcers and the oxygen perfusion of skin flaps. This method employs near-infrared light to evaluate the levels of oxygenated and deoxygenated hemoglobin within the tissue, which is crucial for determining tissue oxygenation and predicting wound healing outcomes. The technology operates on the principle that tissue is relatively transparent to near-infrared light, allowing it to penetrate the skin and reflect differently based on the oxygenation status of the blood. By using a noncontact handheld device, such as SnapshotNIR, healthcare professionals can measure the oxygenation levels in the capillary bed without direct contact with the skin. The device emits six distinct wavelengths of near-infrared light, which are absorbed variably by oxygenated and deoxygenated hemoglobin molecules. The light that is not absorbed is reflected back to the device, where it is recorded and analyzed. The proprietary software associated with the device processes this data to calculate the oxygen saturation levels at each pixel, resulting in a color-coded map that visually represents the oxygenation status alongside the clinical image. This comprehensive analysis culminates in a detailed report that outlines the healing progress of the wound or the viability of the skin flap, thereby aiding in predicting the healing trajectory. The insights gained from this procedure are instrumental in mitigating risks associated with wound healing and enhancing overall patient outcomes.

1. Indications

The noncontact near-infrared spectroscopy (NIRS) procedure is indicated for various clinical scenarios where assessment of tissue oxygenation is critical. The following conditions and situations warrant the use of this imaging technique:

Wound Assessment This procedure is commonly performed to evaluate the oxygenation levels in wounds, particularly diabetic ulcers, to monitor healing progress.
Skin Flap Viability NIRS is utilized to assess the perfusion of skin flaps, ensuring that the tissue is receiving adequate oxygenation for survival and healing.
Biologic Wound Matrix Applications The technique aids in predicting the success of biologic wound matrix applications by providing insights into tissue oxygenation.

2. Procedure

The noncontact near-infrared spectroscopy procedure involves several key steps to ensure accurate measurement and interpretation of tissue oxygenation. The following procedural steps outline the process:

Step 1: Patient Preparation The patient is positioned comfortably, and the area of interest is exposed to allow for unobstructed access to the skin. It is essential to ensure that the skin is clean and free from any obstructions that may interfere with the imaging process.
Step 2: Device Positioning The handheld noncontact device, such as SnapshotNIR, is held over the targeted anatomical site. Care is taken to maintain the appropriate distance as specified by the device's operational guidelines to ensure optimal light penetration and measurement accuracy.
Step 3: Light Emission The device emits six near-infrared electromagnetic wavelengths of light directed towards the tissue. These wavelengths are specifically chosen for their ability to be absorbed differently by oxygenated and deoxygenated hemoglobin.
Step 4: Data Collection The light that is not absorbed by the tissue is reflected back to the device. The device captures this reflected light and records the data for analysis.
Step 5: Data Analysis The proprietary calculation software processes the reflected light data to assess the oxygen saturation levels at each pixel. This analysis results in a detailed color-coded map that visually represents the oxygenation status of the tissue.
Step 6: Reporting A comprehensive report is generated, detailing the findings related to healing progress or flap viability. This report is crucial for guiding clinical decisions and patient management.

3. Post-Procedure

After the noncontact near-infrared spectroscopy procedure, there are no specific post-procedure care requirements mentioned. However, it is essential for healthcare providers to review the generated report with the patient and discuss the implications of the findings. Continuous monitoring of the wound or flap may be necessary based on the results, and follow-up assessments should be scheduled as needed to ensure optimal healing and patient outcomes.

Short Descr	NCNTC IFR SPCTRSC O/T PAD EA
Medium Descr	NCNTC NR IFR SPECTRSC OTH/THN PAD EA ANTMC SITE
Long Descr	Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (List separately in addition to code for primary procedure)
Status Code	Carriers Price the Code
Global Days	ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Items and Services Packaged into APC Rates
Berenson-Eggers TOS (BETOS)	none
MUE	1

This is an add-on code that must be used in conjunction with one of these primary codes.

0640T

Resequenced code MPFS Status: Carrier Priced APC T Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; first anatomic site

LT	Left side (used to identify procedures performed on the left side of the body)
76	Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
AF	Specialty physician
FS	Split (or shared) evaluation and management visit