How To Use CPT Code 78015

CPT 78015 describes the imaging procedure used to determine if thyroid cancer has spread to other parts of the body. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78015?

CPT 78015 is a diagnostic nuclear medicine procedure used to evaluate whether thyroid cancer has metastasized to other areas of the body. It involves the use of a radionuclide to visualize the functioning and morphology of the thyroid gland. This code is specifically used for limited area imaging, such as the neck and chest.

2. Official Description

The official description of CPT code 78015 is: ‘Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only).’ This code is used to determine if thyroid cancer has spread beyond the thyroid gland to other parts of the body.

3. Procedure

1. During a thyroid scan, a nuclear radiologist administers a radioactive substance, either orally or through injection, to the patient.
2. The radiologist then measures radiation levels in the thyroid at various intervals, typically starting 20 minutes after administration and continuing up to 24 hours.
3. Imaging studies are performed to evaluate the location, size, and morphology of the thyroid gland. This may involve intravenous injection of a radiopharmaceutical or oral administration, with images taken at specific time intervals.
4. The images obtained help the nuclear radiologist detect and quantify the presence of thyroid carcinoma metastases in limited areas, such as the neck and chest.

4. Qualifying circumstances

CPT 78015 is used for patients who have been diagnosed with thyroid cancer and require imaging to determine if the cancer has spread beyond the thyroid gland. The procedure is typically performed when there is suspicion or evidence of metastases in limited areas, such as the neck and chest. It is important to note that this code specifically applies to imaging for thyroid carcinoma metastases and not for other thyroid conditions.

5. When to use CPT code 78015

CPT code 78015 should be used when a patient with thyroid cancer undergoes imaging to evaluate the presence of metastases in limited areas, such as the neck and chest. It is important to ensure that the imaging is specifically focused on thyroid carcinoma metastases and not for other purposes, such as general thyroid evaluation or assessment of other conditions.

6. Documentation requirements

To support a claim for CPT 78015, the documentation should include:

• Confirmation of the patient’s diagnosis of thyroid cancer
• Indication for the imaging procedure to evaluate thyroid carcinoma metastases
• Details of the radioactive substance administered and the route of administration
• Timing of radiation measurements and imaging studies
• Interpretation of the images obtained, including any findings related to thyroid carcinoma metastases
• Signature of the nuclear radiologist performing or supervising the procedure

7. Billing guidelines

When billing for CPT 78015, it is important to ensure that the procedure is performed for the specific purpose of evaluating thyroid carcinoma metastases in limited areas. This code should not be reported for general thyroid imaging or assessment of other conditions. Additionally, it is important to follow any specific guidelines or requirements set by the payer or insurance company regarding documentation and medical necessity.

8. Historical information

CPT 78015 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a history of thyroid cancer undergoes a limited area thyroid scan to evaluate for metastases in the neck and chest.
2. A nuclear radiologist administers a radioactive substance orally to a patient with thyroid cancer and performs imaging studies to assess for metastases in limited areas.
3. During a follow-up appointment for thyroid cancer, a nuclear radiologist performs a limited area thyroid scan to monitor for any signs of metastases.
4. A patient with a recent diagnosis of thyroid cancer undergoes a limited area thyroid scan to determine the extent of the disease.
5. A nuclear radiologist performs a limited area thyroid scan on a patient with suspected thyroid carcinoma metastases to confirm the presence and location of the metastases.
6. Following treatment for thyroid cancer, a patient undergoes a limited area thyroid scan to assess the effectiveness of the treatment and detect any residual or recurrent disease.
7. A nuclear radiologist administers a radioactive substance through injection to a patient with thyroid cancer and performs imaging studies to evaluate for metastases in limited areas.
8. During a preoperative evaluation for thyroid cancer, a nuclear radiologist performs a limited area thyroid scan to determine the extent of the disease and guide surgical planning.
9. A patient with a history of thyroid cancer undergoes a limited area thyroid scan as part of a surveillance protocol to monitor for any signs of metastases.
10. A nuclear radiologist performs a limited area thyroid scan on a patient with thyroid cancer to assess the response to targeted therapy and identify any new metastases.