How To Use CPT Code 78070

CPT 78070 describes the imaging procedure used to visualize the parathyroid glands and identify any abnormal tissue. 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 78070?

CPT 78070 is a code used to describe a diagnostic nuclear medicine procedure called parathyroid planar imaging. This procedure involves the use of two different radiopharmaceuticals or radioactive tracers to image the parathyroid glands. The provider takes two sets of images and compares them to identify any abnormal tissue. If necessary, a subtraction study may be performed to aid in the identification of abnormal parathyroid tissue.

2. Official Description

The official description of CPT code 78070 is: ‘Parathyroid planar imaging (including subtraction, when performed).’ This code falls under the range of Diagnostic Nuclear Medicine Procedures on the Endocrine System (78012-78099).

3. Procedure

1. The provider begins by positioning the patient appropriately and verifying the positioning.
2. Two different radiopharmaceuticals or radioactive tracers are administered to the patient.
3. The provider takes early and delayed planar images of the neck and mediastinum using a Gamma camera.
4. If necessary, additional images of the neck may be taken during each tracer administration.
5. The provider digitally stores the acquired studies and manipulates and compares the images with other clinical data.
6. If a subtraction study is performed, the provider compares the two sets of images to distinguish abnormal parathyroid tissue from normal tissue.
7. The provider reviews the findings with the ordering physician, dictates the nuclear medicine report, and signs it.

4. Qualifying circumstances

CPT 78070 is used when there is a need to visualize the parathyroid glands and identify abnormal tissue. This procedure is typically performed to identify conditions such as parathyroid adenomas, parathyroid carcinoma, or hyperplastic parathyroid glands. The provider must administer two different radiopharmaceuticals or radioactive tracers and compare the images to distinguish abnormal tissue from normal tissue.

5. When to use CPT code 78070

CPT code 78070 should be used when performing parathyroid planar imaging with or without subtraction. It is important to note that if SPECT dual phase imaging is performed with limited planar imaging, CPT code 78071 should be reported instead. This code should only be used when there is a need to visualize the parathyroid glands and identify abnormal tissue.

6. Documentation requirements

To support a claim for CPT code 78070, the provider must document the following information:

• Reason for performing the parathyroid planar imaging
• Details of the radiopharmaceuticals or radioactive tracers administered
• Date and time of the imaging procedure
• Images acquired during the procedure
• Comparison of the images and any findings of abnormal tissue
• Review and signature of the provider on the nuclear medicine report

7. Billing guidelines

When billing for CPT code 78070, it is important to ensure that the documentation supports the use of this specific code. If only the physician’s interpretation is being reported, the professional component modifier 26 should be appended to the radiology code. If only the technical component is being reported, modifier TC should be appended. However, it is important to note that payer policies may exempt hospitals from appending modifier TC. It is also important to avoid billing for multiple units as multiple imaging is common and inherent in the resources required for this procedure.

8. Historical information

CPT code 78070, which describes parathyroid planar imaging, has undergone historical changes. It was added to the Current Procedural Terminology system on January 1, 2013. Prior to that, it was referred to as parathyroid imaging. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes parathyroid planar imaging to identify the presence of a parathyroid adenoma.
2. A provider performs parathyroid planar imaging to evaluate a patient with suspected hyperplastic parathyroid glands.
3. Parathyroid planar imaging is performed on a patient to assess the presence of parathyroid carcinoma.
4. A provider utilizes parathyroid planar imaging to visualize the parathyroid glands and determine the cause of abnormal calcium and phosphorus metabolism.
5. A patient undergoes parathyroid planar imaging to assess the function and structure of the parathyroid glands prior to surgery.
6. Parathyroid planar imaging is performed on a patient with persistent hypercalcemia to identify any abnormal parathyroid tissue.
7. A provider utilizes parathyroid planar imaging to evaluate a patient with recurrent kidney stones and suspected parathyroid dysfunction.
8. Parathyroid planar imaging is performed on a patient with primary hyperparathyroidism to identify the location of abnormal parathyroid tissue.
9. A patient undergoes parathyroid planar imaging to assess the function of the parathyroid glands following thyroid surgery.
10. A provider performs parathyroid planar imaging to evaluate a patient with symptoms of hypercalcemia and suspected parathyroid adenoma.