How To Use CPT Code 78232

CPT 78232 describes the evaluation of salivary gland function 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 78232?

CPT 78232 can be used to evaluate the function of the salivary glands by injecting the patient with a radiopharmaceutical or tracer. The provider then uses a gamma camera to detect the tracer and produce images that assess the pattern of uptake and the gland’s secretion of the tracer. This procedure is also known as parotid gland scintigraphy.

2. Official Description

The official description of CPT code 78232 is the evaluation of salivary gland function after intravenous injection of a radiopharmaceutical or tracer. The provider takes continuous or sequential images, beginning immediately after the injection, to observe the accumulation of the tracer in the glands. After a waiting period, the patient is given a sour substance to stimulate salivary gland excretion, and another set of images is taken for comparison. The provider interprets the results and prepares the nuclear medicine report.

3. Procedure

1. The provider injects the patient with a radiopharmaceutical or tracer, such as technetium 99.
2. Using a gamma camera, the provider takes continuous or sequential images of the salivary glands, starting immediately after the injection.
3. After a waiting period, the patient is given a sour substance to stimulate salivary gland excretion.
4. Another set of images is taken to compare the accumulation of the tracer before and after stimulation.
5. The provider calculates the uptake of the tracer and interprets the results.
6. The provider prepares the nuclear medicine report, which includes the findings and their significance.

4. Qualifying circumstances

CPT 78232 is used to evaluate symptoms of persistent dry mouth and salivary gland swelling caused by infection, inflammation, or obstruction. The procedure helps assess the size, shape, and function of the salivary glands. It is typically performed by a provider trained in nuclear medicine.

5. When to use CPT code 78232

CPT code 78232 should be used when evaluating salivary gland function using a radiopharmaceutical or tracer. It is appropriate when there are symptoms of persistent dry mouth or salivary gland swelling, and when the provider needs to assess the size, shape, and function of the salivary glands. This code should not be used for serial imaging without a function study.

6. Documentation requirements

To support a claim for CPT 78232, the provider must document the following information:

• Patient’s symptoms and the need for salivary gland function evaluation
• Type of radiopharmaceutical or tracer used
• Date and time of the procedure
• Images taken before and after stimulation
• Uptake of the tracer and interpretation of the results
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 78232, ensure that the procedure is performed by a provider trained in nuclear medicine. The professional component modifier 26 should be appended if reporting only the physician’s interpretation. The technical component modifier TC should be appended if reporting only the technical component. However, payer policy may exempt hospitals from appending modifier TC. If one provider renders both the professional and technical components, no modifier is necessary.

8. Historical information

CPT 78232 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 presents with persistent dry mouth and swelling of the salivary glands. The provider performs CPT 78232 to evaluate the function of the salivary glands and assess any abnormalities.
2. A patient has a history of salivary gland infections and experiences recurrent swelling. The provider uses CPT 78232 to evaluate the function of the salivary glands and determine the cause of the recurrent infections.
3. A patient undergoes radiation therapy for head and neck cancer and develops dry mouth as a side effect. The provider performs CPT 78232 to evaluate the function of the salivary glands and assess the impact of the radiation therapy.
4. A patient presents with a salivary gland stone causing obstruction and swelling. The provider uses CPT 78232 to evaluate the function of the salivary glands and determine the location and extent of the obstruction.
5. A patient experiences persistent dry mouth and difficulty swallowing. The provider performs CPT 78232 to evaluate the function of the salivary glands and identify any abnormalities that may be causing the symptoms.
6. A patient has a history of autoimmune diseases and presents with salivary gland swelling. The provider uses CPT 78232 to evaluate the function of the salivary glands and assess any autoimmune-related damage.
7. A patient undergoes surgery for salivary gland tumors and experiences post-operative complications. The provider performs CPT 78232 to evaluate the function of the remaining salivary glands and monitor for any complications.
8. A patient presents with recurrent salivary gland infections and swelling. The provider uses CPT 78232 to evaluate the function of the salivary glands and determine the underlying cause of the recurrent infections.
9. A patient has a history of radiation therapy for head and neck cancer and develops salivary gland dysfunction. The provider performs CPT 78232 to evaluate the function of the salivary glands and assess the impact of the radiation therapy on their function.