Nuclear Medicine! Radiology!

As you may remember, major changes including revisions, additions, and deletions were finalized in 2020 for (SPECT/CT) and myocardial PET for nuclear medicine services. Medical coders across the country may still struggle with understanding how and when to report related CPT® codes. Let’s break down some tips for code 78800 to give greater understanding and confidence.

93594abnormal native connections
93595Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections
93596Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections
77049Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis) when performed; bilateral
93597abnormal native connections
+93598Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects
(List separately in addition to code for primary procedure)

How is 78800 used?

Planar imaging using a radiotracer is localized to a single area (i.e., abdomen, chest, breast, neck, etc.). An organ-specific planar imaging CPT code takes precedent as  a coding choice when one is available.

What tips do I need to know for coding success?

  • If planar imaging of a single area is performed over multiple days, see 78801.
  • CPT 78800 may be used for breast imaging studies with 99mTc sestamibi on traditional gamma planar cameras or with breast-specific gamma imaging (BSGI) equipment. Imaging both or one breast(s) would be considered a single area study.
  • If planar imaging is performed on the same day, or next day as part of a whole-body scan, do not report CPT 78800 twice or in addition to other nuclear medicine CPT codes as delayed or single planar imaging is part of any other higher-level nuclear medicine procedure.
  • Understand this code may be reported for planar studies using technetium PYP for cardiac amyloidosis as the area is a single area of the heart or chest region.
  • Note that CPT code 78800 can also be used for imaging inflammation or abscess agents, however, when performing imaging using bone agents for inflammatory disease, see codes 78300, 78305, 78306, or 78315.

Below is a coding case study that demonstrates 78800.


CASE: NUCLEAR MEDICINE CARDIAC AMYLOIDOSIS WITH PYROPHOSPHATE (PYP)

CLINICAL HISTORY

75-year-old presents with cardiomyopathy.

PROCEDURE

Radiopharmaceutical: 21 mCi technetium 99m pyrophosphate. Anterior, LAO, and left lateral projections of the chest were obtained.

IMPRESSION

There is intense diffuse uptake of activity in the left ventricle, greater intensity than bone. Activity is also seen in the right ventricle, similar intensity to bone.

CONCLUSION

Findings support a diagnosis of ATTR amyloidosis. This is a grade 3 scan.

CPT/HCPCS CodeUnits for this ClaimMAIMUE
78800121
A9538131

Check out our 2021 Nuclear Medicine Coding, Reimbursement & Compliance Review for further expert insight on (SPECT/CT) and myocardial PET CPT coding and other important topics to master success.

Facebook
Twitter
LinkedIn
Email
Print

You May Also Like

Ultrasound in physical therapy

Complete vs. Limited Ultrasound

It’s no secret that many CPT® codes for ultrasounds make a distinction between a ‘limited’ exam and a ‘complete’ exam. From a coding standpoint, it’s made fairly clear that in order to report a complete exam, all required components for the complete exam must be imaged and documented.

Read More

Leave a Reply

Your Name(Required)
Your Email(Required)

Subscribe

Subscribe to receive our News, Insights, and Compliance Question of the Week articles delivered right to your inbox.

Resources You May Like

2023 Laboratory Coding Update

2023 Laboratory Coding Update

Empower you and everyone on your team with actionable solutions for laboratory coding, billing and documentation, plus the practical application of code changes for 2023.

December 15, 2022
Register Now

2023 Radiology Coding Update

One convenient webcast breaks down the ins and outs of 2023 CPT®/HCPCS code changes impacting both diagnostic and interventional radiology, and you will walk away with actionable insight on how to avoid high-risk practices.

December 14, 2022
Register Now
Hospital Outpatient Infusion Services: 2023 Reimbursement & Compliance Update

Hospital Outpatient Infusion Services: 2023 Reimbursement & Compliance Update

Coding and compliance mean more than ever to your bottom line in these trying times. Take away essential knowledge and actionable tips for resolving costly ongoing issues, from often lacking documentation for start and stop times, to properly charging for prolonged infusions, to ensuring medical necessity for hydration therapy and drug administration – both current audit targets.

December 8, 2022
Register Now

Trending News