CPT® Code 78135

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The CPT® Code 78135 refers to a red cell survival study that assesses the differential organ and tissue kinetics, specifically focusing on the sequestration of red blood cells (RBCs) in organs such as the spleen and liver. This laboratory test is crucial for evaluating the lifespan of red blood cells, particularly in patients presenting with anemia where a hemolytic cause is suspected. Under normal physiological conditions, red blood cells have a lifespan of approximately 110 to 120 days, after which they undergo senescence due to natural wear and tear. A lifespan of less than 100 days may indicate the presence of hemolysis, a condition where red blood cells are destroyed prematurely. The procedure begins with the collection of a blood sample from the patient to establish a baseline microhematocrit. Subsequently, the red blood cells are tagged with the radioactive isotope tracer, Chromium-51 (Cr-51) Sodium Chromate. After incubation, these tagged RBCs are reintroduced into the patient's bloodstream via intravenous injection. The patient is then required to return for a series of daily venipunctures, typically ranging from 10 to 21 days, to collect blood samples for ongoing microhematocrit analysis. In addition to the blood sampling, the procedure includes scintillation imaging every other day. This involves the use of an uptake counting probe placed over the liver, spleen, and/or precordium for a duration of 10 minutes at each site. Scintillation detectors, which may consist of large field of view gamma cameras with one to three heads or a ring detector, are employed to measure the activity in these organs, allowing for the identification of specific areas of hemolysis. To ensure consistency in the assessment, the patient's skin is marked with permanent ink, indicating the precise locations to be evaluated during each imaging session. The liver is scanned along the midclavicular line while the patient is in a supine position, the precordium is scanned in the third intercostal space at the left sternal border, and the spleen is scanned with the patient in a prone position at the ninth to tenth ribs. Finally, the physician interprets the scintigraphy images and compiles a written report detailing the findings alongside the laboratory data obtained from the venous blood samples.