How To Use CPT Code 78580

CPT 78580 describes the diagnostic procedure of pulmonary perfusion imaging using a radioactive tracer to evaluate blood circulation in the lungs. 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 78580?

CPT 78580 can be used to describe a diagnostic procedure in which a healthcare provider performs pulmonary perfusion imaging using a radioactive tracer. This test is conducted to evaluate the circulation of blood within the patient’s lungs and identify any blood clots that may impede normal blood flow. The code represents both the technical and professional components of the service.

2. Official Description

The official description of CPT code 78580 is: ‘Pulmonary perfusion imaging (eg, particulate).’ This code represents the technical and professional components of a service in which a radioactive substance is injected into a vein in the patient’s arm. The tracer travels through the bloodstream and into the lungs, where planar images are obtained using a gamma camera to detect the emitted gamma rays. These images help the provider assess areas of the lungs with inadequate blood supply.

3. Procedure

1. In this diagnostic procedure, the provider injects a radioactive tracer into a vein in the patient’s arm.
2. The tracer travels through the bloodstream and into the lungs.
3. Using a gamma camera, the provider obtains planar images of the lungs, which show areas with insufficient blood supply.

4. Qualifying circumstances

CPT 78580 is used when a healthcare provider needs to evaluate the circulation of blood within the patient’s lungs. This procedure is typically performed to identify the presence of blood clots that may obstruct normal blood flow. It is important to note that this code represents both the technical and professional components of the service.

5. When to use CPT code 78580

CPT code 78580 should be used when a healthcare provider performs pulmonary perfusion imaging using a radioactive tracer to assess blood circulation in the lungs. This code is appropriate for cases where the provider is evaluating the presence of blood clots or other abnormalities affecting blood flow within the lungs.

6. Documentation requirements

To support a claim for CPT code 78580, the healthcare provider must document the following information:

• Indication for the procedure, such as suspected blood clots or impaired blood circulation in the lungs
• Details of the radioactive tracer used
• Date and time of the procedure
• Images obtained during the procedure
• Interpretation of the images by the provider
• Signature of the provider performing the service

7. Billing guidelines

When billing for CPT code 78580, it is important to ensure that the provider is reporting both the technical and professional components of the service. If only the professional component is being reported, modifier 26 should be appended to the code. If only the technical component is being reported, modifier TC should be appended. However, it is essential to review payer policies, as hospitals may be exempt from appending modifier TC. Additionally, if the radiopharmaceutical substance is billed separately, the appropriate code should be used.

8. Historical information

CPT code 78580 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2012, to its current description of ‘Pulmonary perfusion imaging, particulate.’

9. Examples

1. A healthcare provider performs pulmonary perfusion imaging using a radioactive tracer to evaluate blood circulation in the lungs of a patient suspected of having a blood clot.
2. During the procedure, the provider injects a radioactive substance into the patient’s arm and obtains planar images of the lungs using a gamma camera.
3. The images reveal an area of the lungs with reduced blood supply, indicating a potential blood clot.
4. Based on the findings, the provider recommends further diagnostic tests and treatment for the patient.
5. In another case, a provider performs pulmonary perfusion imaging to assess blood circulation in the lungs of a patient with a history of pulmonary embolism.
6. The procedure helps the provider monitor the patient’s condition and evaluate the effectiveness of treatment.
7. By comparing current and previous images, the provider can identify any changes in blood circulation and adjust the treatment plan accordingly.
8. These examples demonstrate the use of CPT code 78580 in evaluating blood circulation in the lungs and diagnosing conditions such as blood clots or pulmonary embolism.
9. It is important for healthcare providers to accurately document the procedure and findings to support proper billing and ensure appropriate reimbursement.
10. By using CPT code 78580, providers can accurately report and document the diagnostic procedure of pulmonary perfusion imaging.