CPT® Code 78195

The CPT® Code 78195 refers to the imaging of the lymphatic system and lymph nodes, a critical procedure used to evaluate the structure and function of lymphatic vessels. This imaging technique is essential for identifying metastatic disease, which is the spread of cancer from one part of the body to another, and for quantifying lymphedema, a condition characterized by swelling due to lymph fluid accumulation. The lymphatic system is a complex network of vessels that transport lymph fluid, which contains lymphocytes—white blood cells that play a vital role in the immune response—as well as various substances such as viruses, bacteria, pollen, toxins, and malignant cells. These harmful agents are filtered and trapped by lymph nodes, which act as a defense mechanism for the body. One of the most common methods for performing this imaging is lymphoscintigraphy, which utilizes a radiolabeled isotope tracer, specifically 18-F-FDG (Fluorodeoxyglucose). This procedure may be conducted with or without the addition of Single Photon Emission Computed Tomography (SPECT), a technique that enhances the imaging quality by providing three-dimensional representations of the lymphatic structures. In cases of malignant disease, lymphoscintigraphy is particularly useful for identifying sentinel lymph nodes, which are the first nodes to receive lymphatic drainage from a tumor. This information is crucial for planning biopsies, surgical staging, and developing treatment plans. During the imaging process, a gamma camera is employed to detect the radioactive energy emitted from the patient's body, converting this energy into visual images. For patients diagnosed with melanoma, the procedure typically involves administering 2-5 injections of the radiolabeled tracer into the interstitial tissue surrounding the tumor site. The patient is then positioned on an X-ray table, and imaging is conducted over a period of 1-2 hours. In breast cancer patients, the tracer is injected at multiple sites within the breast, chest, and axilla, with imaging taking place over a duration of 30 minutes to more than 2 hours. When evaluating lymphedema, the tracer is injected between the first and second digits of the hand or foot, and the affected extremity is scanned for a period ranging from 30 minutes to over 3 hours. In cases of unilateral lymphedema, both the affected and unaffected limbs are scanned to provide a comprehensive assessment. Additionally, patients may be instructed to perform mild exercises during the study to enhance the flow and uptake of the radiolabeled isotope. Following the imaging, the physician interprets the scintigraphic and/or SPECT images and generates a written report detailing the findings.