AHA Coding Clinic® for HCPCS - 2019 Issue 2; Ask the editor

HIDA duct scan

The hepatobiliary (HIDA) duct scan is a nuclear medicine imaging test performed to evaluate whether there are any blockages in the biliary system which includes the liver, gallbladder and the ducts. However, there is a shortage of the medication cholecystokinin (CCK) which is known as a diagnostic aid used to help diagnose medical conditions. We have been performing the HIDA scan using a dietary replacement (Ensure) for the pharmacologic intervention piece of this procedure. Our office has been reporting CPT code 78227, Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed, for the HIDA scan. We are still doing the calculations for the ejection fraction with Ensure instead of CCK. Would it be appropriate to report CPT code 78227, for the HIDA scan when the Ensure dietary supplement is used in place of cholecystokinin? ...

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