Radiology Question for the Week of June 10, 2024

Question:

How should reimbursement be handled when a SPECT code is reported with a whole body code?

Answer:

When a SPECT code is reported with a whole body code, the SPECT code should be reimbursed at 100 percent, and the whole body code at 50 percent. If the SPECT is a SPECT/CT, the same principle holds in that a SPECT or a SPECT/CT may be billed with a whole body or a whole body over two days. The higher priced study is paid at 100 percent and the lower priced of the two is paid at 50%. This is a long-standing policy set by CMS.

This question was answered in our Nuclear Medicine & PET Coder. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

CPT® copyright 2023 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.

Unlock 50% off all 2024 edition books when you order by July 5! Use the coupon code CO5024 at checkout to claim this offer!

Honor Memorial Day with Savings! Get 20% off all items using code MEMORIAL24 at checkout. Shop today and save! Offer valid until May 31. Exclusions apply.

Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’  is just $99 for a limited time! Use code WorldHealth24 at checkout.