CPT® Code 75889

The CPT® Code 75889 refers to a specialized radiological procedure known as hepatic venography, which involves the detailed imaging of the hepatic veins. This procedure can be performed in two ways: wedged or free, depending on the specific technique used to measure hepatic venous pressures. The primary goal of hepatic venography is to evaluate the hemodynamics of the liver, which includes assessing blood flow and pressure within the hepatic veins. During the procedure, a physician conducts radiological supervision and interpretation, ensuring that the imaging is performed accurately and that the results are properly analyzed. To initiate the procedure, a catheter is inserted into the hepatic vein, and a radiopaque contrast material is injected to enhance the visibility of the veins on the radiographs. The physician monitors the flow of blood through the hepatic veins and their branches, which is crucial for diagnosing various hepatic conditions. The procedure also involves obtaining wedged or free hepatic venous pressures, which are essential for understanding the hemodynamic status of the liver. In the case of wedged hepatic venous pressure measurement, a balloon-tipped catheter is used to occlude a distal hepatic vein branch, allowing for the assessment of pressure in that specific area. Conversely, free hepatic venous pressure is measured without balloon inflation, providing a different perspective on the venous pressure dynamics. The physician utilizes fluoroscopic imaging to ensure the catheter is correctly positioned and to visualize the flow of contrast material, which should demonstrate parenchymal blushing without any reflux. Ultimately, the physician reviews the obtained radiographs and compiles a written interpretation of the findings, which may include calculations of the hepatic venous pressure gradient to estimate portal venous pressure. This comprehensive evaluation is critical for diagnosing and managing various liver-related conditions.