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Coding for hepatobiliary system imaging, including gallbladder, using contrast

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Q.

In the past, we used Kinevac® (sincalide for injection) to stimulate contraction of the gallbladder for our hepatobiliary scans and we want to start using it again. What code do we use? 

A.

The Level ll HCPCS code for Kinevac® is J2805 and it is billed per 5 mcg. The CPT code for a hepatobiliary scan with Kinevac® would be 78227. 

The code and full description are as follows:

78227 Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed

INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION

KINEVAC® (Sincalide for Injection)

Indications

KINEVAC® (Sincalide for Injection), is indicated in adults to:

  • stimulate gallbladder contraction, as may be assessed by various methods of diagnostic imaging, or to obtain by duodenal aspiration a sample of concentrated bile for analysis of cholesterol, bile salts, phospholipids, and crystals
  • stimulate pancreatic secretion (especially in conjunction with secretin) prior to obtaining a duodenal aspirate for analysis of enzyme activity, composition, and cytology
  • accelerate the transit of a barium meal through the small bowel, thereby decreasing the time and extent of radiation associated with fluoroscopy and x-ray examination of the intestinal tract

 

IMPORTANT SAFETY INFORMATION

Contraindications

KINEVAC is contraindicated in patients with a history of hypersensitivity to sincalide, including anaphylaxis and anaphylactic shock, or in patients with intestinal obstruction.

Warnings and Precautions

Post-marketing anaphylaxis, anaphylactic shock, and other serious hypersensitivity reactions have been reported during and within one hour following administration of Kinevac. If anaphylaxis or other hypersensitivity reactions occur, immediately discontinue the infusion and initiate appropriate medical treatment.

Stimulation of gallbladder contraction can lead to small gallbladder stone evacuation, resulting in lodging in the cystic duct or in the common bile duct.

Kinevac may cause adverse reactions such as nausea, vomiting, abdominal pain or cramping, dizziness, and flushing. To reduce the risk of adverse reactions, administer Kinevac over 50 minutes for simulation of gallbladder contraction or over 30 minutes to accelerate transit of a barium meal through the small intestine.

Pregnant patients should be advised that Kinevac can effect smooth muscle, which may cause spontaneous abortion or premature induction of labor.

The most common adverse reactions (≥ 20%) include abdominal discomfort or pain, and nausea.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please click here to see the accompanying full Prescribing Information for Kinevac (Sincalide for Injection).

Kinevac is manufactured for Bracco Diagnostics Inc., Monroe Township, NJ 08831, by Fresenius Kabi USA, LLC, Spokane, WA 99207.

Kinevac is a registered trademark of Bracco Diagnostics Inc.