Radiology Question for the Week of June 10, 2024


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


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.

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