How To Use CPT Code 78305

CPT 78305 describes the bone and/or joint imaging procedure that allows healthcare providers to examine multiple areas of the skeleton and diagnose bone diseases. 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 78305?

CPT 78305 can be used to describe the bone and/or joint imaging procedure performed by healthcare providers. This specialized nuclear medicine procedure involves injecting a radionuclide (tracer) into a vein prior to imaging. The provider then examines multiple areas of the skeleton to diagnose bone diseases or disorders. The focus of the procedure is on specific areas, such as bilateral ankles and knees, both hands and wrists, or the lower spine and pelvis.

2. Official Description

The official description of CPT code 78305 is: ‘Bone and/or joint imaging; multiple areas.’

3. Procedure

1. The healthcare provider injects a radionuclide (tracer) into a vein.
2. After 4-6 hours, the provider images the bones and joints.
3. The procedure focuses on multiple areas of the skeleton, such as bilateral ankles and knees, both hands and wrists, or the lower spine and pelvis.

4. Qualifying circumstances

CPT 78305 is used when a healthcare provider performs bone and/or joint imaging to diagnose bone diseases or disorders. This procedure is typically ordered for conditions such as fractures, osteomyelitis, or metastatic bone disease. The provider must inject a radionuclide (tracer) into a vein and image multiple areas of the skeleton.

5. When to use CPT code 78305

CPT code 78305 should be used when a healthcare provider performs bone and/or joint imaging to examine multiple areas of the skeleton and diagnose bone diseases or disorders. It is important to note that this code should not be used for whole-body imaging.

6. Documentation requirements

To support a claim for CPT 78305, the healthcare provider must document the following information:

• Specific areas imaged, such as bilateral ankles and knees, both hands and wrists, or the lower spine and pelvis
• Date and time of the procedure
• Injection of the radionuclide (tracer)
• Any additional relevant information, such as the reason for the imaging or any specific findings

7. Billing guidelines

When billing for CPT 78305, ensure that the procedure involves imaging multiple areas of the skeleton and the injection of a radionuclide (tracer). 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, it is important to review payer policies as hospitals may be exempt from appending modifier TC. When reporting a global service where one provider renders both the professional and technical components, do not append a professional or technical modifier to the radiology code.

8. Historical information

CPT 78305 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 healthcare provider performs bone and joint imaging on a patient’s bilateral ankles and knees to diagnose a suspected fracture.
2. A radiologist injects a radionuclide (tracer) into a patient’s vein and images both hands and wrists to evaluate for signs of osteomyelitis.
3. A physician orders bone and joint imaging of the lower spine and pelvis to assess for metastatic bone disease in a cancer patient.
4. A healthcare provider performs bone and joint imaging on a patient’s bilateral hips and shoulders to investigate chronic joint pain.
5. A radiologist injects a radionuclide (tracer) into a patient’s vein and images both feet and ankles to evaluate for signs of arthritis.
6. A physician orders bone and joint imaging of the thoracic spine and ribs to assess for possible fractures in a trauma patient.
7. A healthcare provider performs bone and joint imaging on a patient’s bilateral elbows and wrists to evaluate for signs of inflammation in a rheumatoid arthritis patient.
8. A radiologist injects a radionuclide (tracer) into a patient’s vein and images both knees and ankles to assess for signs of infection in a patient with suspected septic arthritis.
9. A physician orders bone and joint imaging of the cervical spine and temporomandibular joints to investigate chronic neck and jaw pain.
10. A healthcare provider performs bone and joint imaging on a patient’s bilateral shoulders and hips to evaluate for signs of degenerative joint disease.