# How would you code for use of SPY to test for tissue perfusion?



## sevolution (Jan 6, 2012)

Hello. What codes would you use to code for the use of SPY, the series of injections to administer the flourescent agent, and the imaging and interpretation of images taken during the procedure? 

I have seen CPT codes 15860 (intravenous injection of agent (e.g. fluroscein) to test vascular flow in flap or graft)  and 76499 (for radigraphic procedure) reported. Is this correct? Also, would you increase the units for CPT 15860 if there is more than one injection?

My surgeons are using SPY to test tissue perfusion duing microsurgery, reconstructive surgery and plastic surgery however I am unsure as to how to capture all that is being done.

Thank you


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## plasticscoder (Jan 24, 2012)

Our pratice also performs SPYs during reconstructive procedures. We bill 15860, which can only be billed once per operative session. In following reimbursement trends, how have payers responded to the unlisted radiographic code?


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## sevolution (May 14, 2012)

Hello. Forgive my delay in getting back to you. I hadn't received a notification that there was a response. 

I wanted to ask if you attempted to use the -76 modifier or not? Also, we are seeing that payors are inconsistent in accepting the unlisted proc codes. Some are, some are not, some are recommending other codes, etc. 

Thank you again for your response.


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## JulieFuhriman (Nov 29, 2012)

I have a surgeon who's using SPY to inject into the colon to test vascular flow.  Is anyone else doing this?  Would 15860 still be the correct code?  Help!
Julie


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## MI_CODER (May 16, 2022)

Coding for ICG Imaging​December 19, 2019

*Question:*
Can you give guidance on CPT 15860 as it pertains to colorectal surgery?
My surgeons have been using this code when they use the isocyanine green fluorescence imaging either with the robot (Firefly) or open (SpyPhi).  They are saying this code is relevant because they are assessing vascular flow in a graft (it’s technically a graft of autologous tissue to replace the removed bowel).

*Answer:*
The infusion of ICG dye as imaging to assess perfusion is inherent to the procedure and not separately reported.
_*This response is based on the best information available as of 12/19/19.



			https://www.karenzupko.com/coding-for-icg-imaging/
		

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