How To Use CPT Code 78103

CPT 78103 describes the imaging of bone tissue using a radiopharmaceutical or tracer. 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 78103?

CPT 78103 can be used to describe the imaging of bone tissue using a radiopharmaceutical or tracer. This code is used when the provider administers the radiopharmaceutical intravenously and uses a gamma camera to capture images of the tracer distribution in the bone. The purpose of this imaging is to evaluate bone marrow activity in various diseases such as metastatic disease, leukemia, unexplained bone pain, osteomyelitis, or to determine the best location for a bone marrow biopsy.

2. Official Description

The official description of CPT code 78103 is: ‘Bone marrow imaging; multiple areas.’

3. Procedure

1. The provider administers a radiopharmaceutical or tracer, such as Tc-99m sulfur colloid, intravenously.
2. The tracer is carried by the patient’s bloodstream and absorbed by the bones.
3. The provider may take images immediately, after a delay, or in phases after a two to four hour wait to allow for bone absorption.
4. A gamma camera is positioned against the body part to be examined, and images of the tracer distribution in the bone are recorded.
5. The provider may move the camera and/or table during the study to capture images from different angles.
6. The recorded images are analyzed to assess for abnormal bone metabolism, which may appear as darker hot spots or brighter cold spots where the tracers have or haven’t accumulated.
7. The provider reviews the findings with the referring physician and prepares a nuclear medicine report.

4. Qualifying circumstances

CPT 78103 is used when the provider performs bone marrow imaging using a radiopharmaceutical or tracer. This procedure is typically done to evaluate bone marrow activity in diseases such as metastatic disease, leukemia, unexplained bone pain, osteomyelitis, or to determine the best location for a bone marrow biopsy.

5. When to use CPT code 78103

CPT code 78103 should be used when the provider performs bone marrow imaging using a radiopharmaceutical or tracer. It is appropriate to bill this code when evaluating bone marrow activity in various diseases or when determining the best location for a bone marrow biopsy.

6. Documentation requirements

To support a claim for CPT 78103, the provider must document the following information:

• Reason for the study and the specific disease or condition being evaluated
• Type of radiopharmaceutical or tracer used
• Date and time of the procedure
• Details of the imaging process, including any delays or phases
• Findings and analysis of the recorded images
• Review of the findings with the referring physician
• Signature of the provider

7. Billing guidelines

When billing for CPT 78103, ensure that the provider performs bone marrow imaging using a radiopharmaceutical or tracer. Follow the appropriate guidelines for reporting the professional and technical components of the service. Modifier 26 should be appended to the radiology code if reporting only the physician’s interpretation, while modifier TC should be appended if reporting only the technical component. However, payer policies may exempt hospitals from appending modifier TC. If reporting a global service in which one provider renders both the professional and technical components, do not append any modifiers to the radiology code.

8. Historical information

CPT 78103 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient with suspected metastatic disease undergoes bone marrow imaging to evaluate bone marrow activity.
2. A provider performs bone marrow imaging to diagnose leukemia in a patient with unexplained symptoms.
3. A patient with chronic bone pain undergoes bone marrow imaging to determine the cause of the pain.
4. A provider uses bone marrow imaging to assess for osteomyelitis in a patient with suspected bone infection.
5. A provider performs bone marrow imaging to determine the best location for a bone marrow biopsy in a patient with a suspected hematologic disorder.
6. A patient with unexplained bone pain undergoes bone marrow imaging to evaluate bone marrow activity.
7. A provider uses bone marrow imaging to assess for metastatic disease in a patient with a history of cancer.
8. A patient with suspected leukemia undergoes bone marrow imaging to confirm the diagnosis.
9. A provider performs bone marrow imaging to evaluate bone marrow activity in a patient with unexplained symptoms.
10. A patient with suspected osteomyelitis undergoes bone marrow imaging to assess for bone infection.