AHA Coding Clinic® for HCPCS - 2012 Issue 4; Ask the Editor

Photon Emission Computed Tomography (SPECT)

Our facility is performing single photon emission computed tomography (SPECT) and planar imaging of the parathyroid. According to National Correct Coding Initiative (NCCI) policy, the SPECT studies “represent an enhanced methodology” more than the standard planar technique used. Also, when a limited anatomic area is studied, no additional information is obtained by performing both studies. Although there is no bundling edit for 78070, Parathyroid imaging, and 78803, Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); tomographic (SPECT), NCCI policy states the SPECT study is not separately reported with the planar study of the same area. However, we have received other advice that both studies can be reported together with the appropriate modifier appended. Our question is if our facility performs both planar and SPECT studies can CPT codes 78070 and 78803 be reported with an appropriate modifier? ...

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