How To Use CPT Code 78598

CPT code 78598 describes the quantitative differential pulmonary perfusion and ventilation procedure, which involves evaluating the circulation of air and blood within the patient’s 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 78598?

CPT 78598 can be used to describe a diagnostic procedure that assesses the circulation of air and blood within the patient’s lungs. It involves performing quantitative analysis of differential pulmonary ventilation and perfusion. This code is used to evaluate conditions such as chronic obstructive pulmonary disease, pneumonia, bronchitis, and other respiratory infections.

2. Official Description

The official description of CPT code 78598 is: ‘Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed.’

3. Procedure

1. The provider administers a radioactive tracer substance into the patient’s vein to assess pulmonary perfusion.
2. The provider uses a gamma camera to take scans of the lungs, detecting the gamma rays emitted by the radioactive tracer substance.
3. The provider also has the patient inhale a radioactive tracer gas or mist to assess pulmonary ventilation.
4. The provider scans images of the lungs using a gamma camera, which detects the gamma rays emitted by the radioactive tracer gas.
5. The images obtained from the scans show areas of the lungs that may have inadequate air circulation or blood flow.
6. The provider performs quantitative analysis of the differential pulmonary ventilation and perfusion to evaluate the patient’s respiratory condition.

4. Qualifying circumstances

CPT 78598 is used for patients who require an assessment of their pulmonary ventilation and perfusion. This procedure is commonly performed to evaluate chronic obstructive pulmonary disease, pneumonia, bronchitis, or other respiratory infections. The provider must use a radioactive tracer substance and a gamma camera to perform the assessment.

5. When to use CPT code 78598

CPT code 78598 should be used when a provider performs a quantitative analysis of differential pulmonary perfusion and ventilation using a radioactive tracer substance and a gamma camera. This code is appropriate for evaluating respiratory conditions that require assessment of air and blood circulation within the lungs.

6. Documentation requirements

To support a claim for CPT 78598, the provider must document the following information:

• Reason for performing the procedure and the patient’s respiratory condition
• Details of the radioactive tracer substance used
• Date and time of the procedure
• Images obtained from the scans and any abnormalities observed
• Quantitative analysis of the differential pulmonary perfusion and ventilation
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 78598, ensure that the procedure involves quantitative analysis of differential pulmonary perfusion and ventilation using a radioactive tracer substance and a gamma camera. This code should not be reported in conjunction with codes 78451-78454. If reporting only the physician’s interpretation, append modifier 26. If reporting only the technical component, append modifier TC. However, payer policy may exempt hospitals from appending modifier TC.

8. Historical information

CPT 78598 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A provider performs quantitative analysis of differential pulmonary perfusion and ventilation to evaluate a patient with chronic obstructive pulmonary disease.
2. A patient with pneumonia undergoes a procedure to assess the circulation of air and blood within their lungs using a radioactive tracer substance and a gamma camera.
3. A provider uses CPT code 78598 to evaluate the pulmonary ventilation and perfusion of a patient with bronchitis.
4. A provider performs a quantitative analysis of differential pulmonary perfusion and ventilation to assess a patient with a respiratory infection.
5. A patient with suspected respiratory issues undergoes a procedure to evaluate the circulation of air and blood within their lungs using a radioactive tracer substance and a gamma camera.
6. A provider uses CPT code 78598 to assess the pulmonary ventilation and perfusion of a patient with suspected chronic obstructive pulmonary disease.
7. A patient with a history of bronchitis undergoes a procedure to evaluate the circulation of air and blood within their lungs using a radioactive tracer substance and a gamma camera.
8. A provider performs quantitative analysis of differential pulmonary perfusion and ventilation to assess a patient with suspected pneumonia.
9. A patient with respiratory symptoms undergoes a procedure to evaluate the circulation of air and blood within their lungs using a radioactive tracer substance and a gamma camera.
10. A provider uses CPT code 78598 to assess the pulmonary ventilation and perfusion of a patient with suspected bronchitis.