Radiology Question for the Week of November 25, 2024

Question:

When performing a gastrointestinal motility study that evaluates both gastric emptying and small bowel transit using dual radioisotope techniques, which factors should guide the selection of CPT®codes 78265 and 78266?

Codes 78265 and 78266 are used to recognize and report the motility of the entire GI tract (i.e., stomach, small bowel, and colon). These exams require the patient to eat, or eat and drink, food that has been impregnated with radioactivity. The more common single isotope solid phase study uses 99mTc SC, usually in scrambled eggs. The liquid phase uses 111In DTPA in a beverage. For small bowel and/or colon transit studies, the more common protocol is a dual radioisotope technique; however, this code may be reported using any protocol. Once the patient ingests the material(s), they are scanned over the next several hours (typically up to 24 to 26 hours), the camera is centered over the stomach and imaging occurs until accumulation in the terminal ileum reservoir is seen. The determining factor in code selection is the intent to analyze and report on both GES and the small bowel for the patient. Computer images are also acquired to allow for the calculation of the percentage of radioactivity emptied, as well as the amount retained.

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