AMA Clinical Examples in Radiology - 2024 Issue 2 (Spring)
Hepatobiliary Imaging with SPECT/CT
Spring 2024 pages 11-15 CLINICAL EXAMPLE 2: Hepatobiliary Imaging with SPECT/CT CLINICAL HISTORY: A 20-year-old male presents with acute duodenitis and severe right upper quadrant abdominal pain. An ultrasound of the right upper quadrant was performed the previous night and showed thickening of the gallbladder wall but was inconclusive for acute cholecystitis. A hepatobiliary iminodiacetic acid (HIDA) scan was requested to assess for acute cholecystitis. PROCEDURE A HIDA scan with single-photon emission computed tomography (SPECT)/computed tomography (CT) images was performed. TECHNIQUE Nuclear medicine hepatobiliary imaging was performed with 3 mCi of technetium tc-99m mebrofenin administered intravenously. An initial anterior arterial...
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Article Overview
This article explains a hepatobiliary imaging scenario using nuclear medicine, SPECT/CT, and associated billing and diagnosis coding references. It is useful for coders, radiology staff, and reimbursement teams who need to understand the general scope of the study, the related code sets, and the kinds of guidance discussed in the example and discussion.
Why This Topic Matters
Hepatobiliary imaging is commonly reported in radiology and nuclear medicine, and this article helps readers identify the relevant procedure, radiopharmaceutical, and diagnosis code sets discussed for similar cases. It also places the imaging example in the context of professional guidance and source references.
Article Sections
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Spring 2024 pages 11-15
Publication and issue information for the clinical example and discussion that follow.
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Clinical Example 2: Hepatobiliary Imaging with SPECT/CT
A patient scenario, imaging workup, and resulting findings are presented to frame the coding discussion.
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Procedure
The imaging service is described at a high level, including the general study type and combined imaging approach.
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Technique
This section summarizes the radiopharmaceutical administration and the major imaging steps used in the study.
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Findings
The imaging observations are reviewed across the liver, biliary system, bowel activity, and upper abdominal structures.
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Impression
The report’s overall diagnostic conclusions are summarized in broad terms.
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How to Code
Coding references and general reporting considerations are discussed for the imaging study and associated diagnoses.
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Discussion
Background information is provided on hepatobiliary scintigraphy, related imaging approaches, and reporting context from professional sources.
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Sources
Referenced professional publications and practice guidance are listed.
What You Will Learn
- The general purpose and structure of hepatobiliary nuclear medicine imaging with SPECT/CT
- The code sets and types of codes referenced in the article
- The kinds of clinical scenarios that lead to hepatobiliary imaging review
- The professional guidance and source types cited in the discussion
- The broad reporting context associated with combined planar and tomographic imaging
Who Should Read This
- Radiology coders
- Nuclear medicine coders
- Radiology billing staff
- Compliance and reimbursement staff
- Clinical documentation reviewers
Codes Discussed
Modifiers Discussed
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