How To Use CPT Code 78013

CPT 78013 describes the imaging of the thyroid gland after the administration of radioiodine. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78013?

CPT 78013 can be used to describe the imaging of the thyroid gland after the administration of radioiodine. This code is used when the provider wants to evaluate any lumps or inflammation, investigate the cause of an overactive thyroid or abnormalities of thyroid anatomy, and assess the size, structure, and function of the thyroid.

2. Official Description

The official description of CPT code 78013 is: ‘Thyroid imaging (including vascular flow, when performed).’ This code is used when the provider images the thyroid gland after the administration of radioiodine to determine the amount that reaches the thyroid. The test allows for the evaluation of various aspects of the thyroid gland.

3. Procedure

1. The provider administers radioiodine to the patient, either in pill form or intravenously.
2. If the provider uses a pill form, the patient is advised to return for imaging within a specific timeframe, usually within 4 hours but possibly up to 24 hours. If the provider uses an intravenous injection, the scan is started within 30-60 minutes.
3. The provider uses a scintillation or gamma camera to image the entire thyroid gland in a single image.
4. The provider scans the thyroid from different angles, acquiring multiple images in various projections, and documents the patient’s position.
5. The provider may also assess the vascular flow in and around nodules to determine benign or malignant flow characteristics and identify the best locations for biopsy.
6. In some cases, the provider may place a radioactive marker near the thyroid gland to estimate the size of the thyroid and the presence and location of nodules.
7. The provider compares the images to any relevant prior studies, interprets the results, and prepares a nuclear medicine report.

4. Qualifying circumstances

CPT 78013 is used for patients who require imaging of the thyroid gland after the administration of radioiodine. This procedure is typically performed to evaluate any lumps or inflammation, investigate the cause of an overactive thyroid or abnormalities of thyroid anatomy, and assess the size, structure, and function of the thyroid. The provider must use a scintillation or gamma camera to perform the imaging.

5. When to use CPT code 78013

CPT code 78013 should be used when the provider performs imaging of the thyroid gland after the administration of radioiodine. This code is appropriate when the provider wants to evaluate various aspects of the thyroid, such as lumps, inflammation, overactivity, abnormalities, size, structure, and function. It is important to note that CPT code 78013 should not be reported together with CPT code 78012 for the same service. Instead, use the comprehensive code CPT 78014 to report the service.

6. Documentation requirements

To support a claim for CPT 78013, the provider must document the following information:

• Patient’s medical history and reason for the imaging
• Type of radioiodine administration (pill or intravenous)
• Date and time of the imaging procedure
• Details of the imaging procedure, including the use of a scintillation or gamma camera, angles and projections used, and the patient’s position
• Comparison to any relevant prior studies
• Interpretation of the results
• Signature of the provider who performed and interpreted the imaging

7. Billing guidelines

When billing for CPT 78013, ensure that the provider performs the imaging of the thyroid gland after the administration of radioiodine. It is important to note that CPT code 78013 should not be reported together with CPT code 78012 for the same service. Instead, use the comprehensive code CPT 78014 to report the service. If reporting only the physician’s interpretation for the radiology service, append professional component modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical. Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 78013 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes thyroid imaging after the administration of radioiodine to evaluate a suspicious lump in their thyroid gland.
2. A provider performs thyroid imaging to investigate the cause of an overactive thyroid in a patient.
3. A patient with a history of thyroid abnormalities undergoes imaging to assess the size, structure, and function of their thyroid gland.
4. A provider performs thyroid imaging to evaluate inflammation in the thyroid gland of a patient with symptoms of thyroiditis.
5. A patient undergoes thyroid imaging to assess the vascular flow in and around nodules in their thyroid gland for biopsy planning.
6. A provider performs thyroid imaging to compare the current images with prior studies and interpret the results for a patient with a known thyroid condition.
7. A patient receives thyroid imaging after the administration of radioiodine to estimate the size of their thyroid gland and identify the presence and location of nodules.
8. A provider performs thyroid imaging to assess the structure and function of the thyroid gland in a patient with suspected thyroid abnormalities.
9. A patient undergoes thyroid imaging to evaluate the size and function of their thyroid gland before a surgical procedure.
10. A provider performs thyroid imaging to assess the vascular flow in and around nodules in a patient with a history of thyroid cancer.