CPT® Code 78291

The CPT® Code 78291 refers to a diagnostic procedure known as the peritoneal-venous shunt patency test, which is specifically utilized for assessing the functionality of shunts such as the LeVeen or Denver shunt. This test is crucial for determining whether the shunt is patent, meaning it is open and functioning as intended. The procedure involves the use of imaging technology that is strategically placed over the patient's abdomen and thorax, allowing healthcare professionals to visualize the pump and shunt tubing effectively. A radiotracer, typically a radioactive substance like TC99m-SC or TC99m-MAA, is injected separately to facilitate this visualization. In the case of a LeVeen shunt, the abdomen is gently massaged to ensure even distribution of the radiotracer, while for a Denver shunt, the patient is instructed to actively pump the system to aid in the process. Following the injection of the radiotracer, an initial anterior abdominal image is captured immediately, followed by a series of images taken every 15 minutes for up to one hour. The expected outcome of a patent shunt is the visualization of the radionuclide in the lungs and/or liver within this timeframe. If no such visualization occurs within the first hour, additional delayed imaging may be performed 2 to 4 hours post-injection. Should there still be no visualization after 4 hours, it indicates that the shunt is obstructed. The entire procedure is supervised by a physician, who is responsible for interpreting the results and providing a written report of the findings.