How To Use CPT Code 78072

CPT 78072 describes the imaging procedure used to identify and localize abnormal parathyroid tissue in the neck. 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 78072?

CPT 78072 is a diagnostic nuclear medicine procedure that involves imaging the parathyroid glands in the neck. The provider administers two different radiopharmaceuticals or radioactive tracers to the patient and takes planar images of the neck and mediastinum using a Gamma camera. The results are then compared to each other, along with SPECT images and concurrently acquired computed tomography (CT) images, to help identify abnormal parathyroid tissue and precisely localize it for surgical planning.

2. Official Description

The official description of CPT code 78072 is: ‘Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT), and concurrently acquired computed tomography (CT) for anatomical localization.’

3. Procedure

1. The provider verifies the patient’s positioning and may administer a sedative to ensure the patient remains still throughout the study.
2. The provider administers the first radioactive tracers and takes early and delayed planar images of the neck and mediastinum using a Gamma camera.
3. The provider administers a subsequent tracer and repeats the planar imaging, taking additional images of the neck as needed.
4. The provider performs a subtraction study if necessary, comparing the two sets of images to distinguish abnormal parathyroid tissue from normal tissue.
5. The provider takes SPECT images using a special camera to create 3-dimensional pictures of the parathyroid gland.
6. The provider concurrently acquires computed tomography (CT) images to further improve anatomical localization of abnormal findings.
7. The provider reviews and compares all the images with other clinical data to identify abnormal parathyroid tissue.
8. The provider dictates, reviews, and signs the nuclear medicine report, discussing the findings with the ordering physician.

4. Qualifying circumstances

CPT 78072 is performed when there is a need to identify and localize abnormal parathyroid tissue in the neck. This may be necessary for patients with suspected parathyroid adenomas, parathyroid carcinomas, or hyperplastic parathyroid glands. The procedure is typically performed by a provider trained in nuclear medicine, and it requires the use of radiopharmaceuticals, a Gamma camera, and concurrent CT imaging for anatomical localization.

5. When to use CPT code 78072

CPT code 78072 should be used when the provider performs parathyroid planar imaging with tomographic (SPECT) and concurrently acquired CT imaging for anatomical localization. This code should not be reported in conjunction with codes 78800, 78801, 78802, 78803, 78804, 78830, 78831, 78832, or 78835.

6. Documentation requirements

To support a claim for CPT 78072, the provider must document the following information:

• Patient’s clinical indication for the study
• Details of the radiopharmaceuticals or radioactive tracers administered
• Date and time of the study
• Specific images acquired, including planar, SPECT, and CT images
• Comparison and analysis of the images to identify abnormal parathyroid tissue
• Discussion of the findings with the ordering physician
• Signature of the provider performing the study

7. Billing guidelines

When billing for CPT 78072, ensure that the procedure includes parathyroid planar imaging with tomographic (SPECT) and concurrently acquired CT imaging for anatomical localization. Do not report CPT 78072 in conjunction with codes 78800, 78801, 78802, 78803, 78804, 78830, 78831, 78832, or 78835. If reporting only the physician’s interpretation, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, payer policies may exempt hospitals from appending modifier TC. It is important to review payer guidelines for specific billing requirements.

8. Historical information

CPT 78072 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 with suspected parathyroid adenoma undergoes parathyroid planar imaging with tomographic (SPECT) and concurrently acquired CT imaging for anatomical localization.
2. A provider performs parathyroid planar imaging with tomographic (SPECT) and concurrently acquired CT imaging for anatomical localization to identify abnormal parathyroid tissue in a patient with hyperplastic parathyroid glands.
3. Parathyroid planar imaging with tomographic (SPECT) and concurrently acquired CT imaging for anatomical localization is performed on a patient with suspected parathyroid carcinoma.
4. A provider uses parathyroid planar imaging with tomographic (SPECT) and concurrently acquired CT imaging for anatomical localization to precisely localize abnormal parathyroid tissue in a patient prior to surgical intervention.
5. Parathyroid planar imaging with tomographic (SPECT) and concurrently acquired CT imaging for anatomical localization is performed on a patient with elevated parathyroid hormone levels to determine the cause of their condition.