AMA Clinical Examples in Radiology - 2020 Issue 4 (Fall)
Indium-111 White Blood Cell Scan
CLINICAL EXAMPLE 2 Indium-111 White Blood Cell Scan CLINICAL DATA A 72-year-old male with left otitis externa is referred for evaluation of possible infection at the skull base. TECHNIQUE Radiopharmaceutical: Indium-111 Oxyquinoline (oxine)–labeled white blood cells (WBCs) 0.449 mCi administered intravenously. A small sample of the patient's blood was collected. The WBCs were separated and labeled with the radiopharmaceutical. The labeled WBCs were reinjected into the patient, followed by delayed planar imaging of the whole body in anterior and posterior projections. Additional spot views of the head and neck were obtained. Single-photon emission computed tomography with concurrently acquired...
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Article Overview
This article reviews a nuclear medicine imaging example involving labeled white blood cell scanning and how the associated study is documented for coding purposes. It is aimed at coders, radiology billing staff, and clinicians who work with nuclear medicine and infection/inflammation imaging. The discussion covers the imaging scenario, related CPT and HCPCS reporting considerations, the linked ICD-10-CM diagnosis, and references to professional guidance.
Why This Topic Matters
Accurate reporting for nuclear medicine studies depends on recognizing the imaging services performed, the radiopharmaceutical supplied, and the related diagnosis information. This article helps readers identify the general coding and documentation elements involved in infection-focused white blood cell imaging.
Article Sections
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Clinical Example 2
Introduces the patient scenario and the imaging study being reviewed.
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Clinical Data
Summarizes the clinical context that prompted the examination.
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Technique
Describes the radiopharmaceutical preparation and the imaging methods performed.
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Comparison
Notes whether prior studies were available for review.
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Findings
Presents the imaging observations from the study.
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Impression
States the overall interpretation of the imaging results.
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How to Code
Discusses the coding framework associated with the study, including procedure, supply, and diagnosis reporting references.
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Discussion
Provides broader background on the imaging modality, reporting context, and general documentation considerations.
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Coding Tip
Highlights a documentation note related to how the service is reported.
What You Will Learn
- What this nuclear medicine example is about
- What types of imaging and documentation are discussed
- What coding categories are referenced for the study
- What broader reporting considerations are covered
- What professional guidance sources are cited
Who Should Read This
- Medical coders
- Radiology billing staff
- Nuclear medicine professionals
- Compliance and reimbursement teams
- Clinical documentation specialists
Codes Discussed
Modifiers Discussed
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