CPT® Code 75860

Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation

The CPT® Code 75860 refers to a specialized radiological procedure known as venography, specifically targeting the venous sinuses, such as the petrosal and inferior sagittal sinuses, or the jugular vein. This procedure involves the use of a catheter to introduce a radiopaque contrast medium, which enhances the visibility of these structures during imaging. Radiological supervision and interpretation are integral components of this procedure, ensuring that the images captured are accurately assessed by a qualified professional. The primary purpose of performing a venography is to diagnose conditions such as hemorrhage or thrombosis, which may arise from various factors including traumatic skull injuries, vascular fistulas, malformations, or tumors. The venous sinuses are critical channels located between the layers of the dura mater in the brain, responsible for draining blood from both external and internal cerebral veins, as well as cerebrospinal fluid from the subarachnoid space. Ultimately, these sinuses direct blood flow into the internal jugular vein (IJV). The inferior sagittal sinus (ISS) plays a significant role in this drainage system, as it empties into the straight sinus, which then connects to the confluence of sinuses and the transverse sinuses before reaching the IJV. Additionally, the superior and inferior petrosal sinuses, which receive drainage from the cavernous sinuses, are also involved in this complex venous network. The superior petrosal sinus drains into the transverse sinuses, while the inferior petrosal sinus drains directly into the IJV. During the procedure, a catheter is typically introduced via a peripheral vein in the arm or directly into the jugular vein. The process begins with the insertion of a fine gauge needle into the chosen blood vessel, followed by the threading of a guidewire through the needle into the jugular vein. To visualize the ISS and cavernous sinuses, contrast may be injected into the carotid arteries. A catheter is then advanced over the guidewire to the designated area for contrast injection, after which the guidewire is removed. The contrast medium is injected, and x-ray films are taken to capture images of the venous structures. Upon completion of the venography, the catheter is removed, and the procedure is documented, including the radiological supervision, interpretation of the images, and a written report detailing the findings.