Practice

Coding Corner

Planar and SPECT Parathyroid Imaging
Planar and SPECT or SPECT/CT Parathyroid Imaging
Revised: May 30, 2013
Question
We are doing planar and SPECT imaging of parathyroids. Should we use the parathyroid CPT code and/or the general SPECT tumor code?
 
Answer
Appropriate coding for parathyroid imaging depends on the protocol/imaging used and the date of service. If planar technique is performed alone (i.e. dual phase imaging of the neck and mediastinum), use CPT 78070 Parathyroid planar imaging (including subtraction, when performed);. If SPECT technique (dual phase imaging of the neck and mediastinum), with limited planar imaging, is done on a date of service prior to January 1, 2013 use CPT 78803 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); tomographic with or without modifiers as necessary, for dates of service on or after January 1, 2013 report CPT code 78071 Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT).

Finally, for services on or after January 1, 2013, if a SPECT/CT is performed for anatomical localization of the parathyroids, rather than a SPECT study with any planar imaging, as noted above, see 78072 Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT), and concurrently acquired computed tomography (CT) for anatomical localization.

The SNMMI coding opinion has changed for parathyroid imaging from 2007 to date, the SNMMI coding committee believes the 2013 new and revised parathyroid CPT codes now accurately reflect todays practice and services provided.

Disclaimer
The opinions referenced are those of the members of the SNMMI Coding and Reimbursement Committee and their consultants based on their coding experience. They are based on the commonly used codes in Nuclear Medicine, which are not all inclusive. Always check with your local insurance carriers as policies vary by region. The final decision for the coding of a procedure must be made by the physician considering regulations of insurance carriers and any local, state or federal laws that apply to the physicians practice. The SNMMI and its representatives disclaim any liability arising from the use of these opinions.