How To Use CPT Code 78608

CPT 78608 describes a diagnostic nuclear medicine procedure known as brain imaging using positron emission tomography (PET) for metabolic evaluation. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78608?

CPT 78608 is used to describe a diagnostic nuclear medicine procedure called brain imaging using positron emission tomography (PET) for metabolic evaluation. This procedure provides three-dimensional images that show how the brain and its tissue are functioning. By injecting a radioactive tracer into the patient’s bloodstream, the provider can track the distribution of the tracer throughout the brain and evaluate its metabolism, such as oxygen, glucose, or drug metabolism.

2. Official Description

The official description of CPT code 78608 is: ‘Brain imaging, positron emission tomography (PET); metabolic evaluation.’

3. Procedure

1. In this procedure, the provider injects a radioactive tracer or radionuclide into the patient’s bloodstream.
2. The radionuclide travels in the bloodstream and reaches the brain.
3. The radionuclide breaks down in the target area, emitting gamma rays.
4. A PET scanner detects the gamma rays given off by the radioactive substance.
5. The computer processes the emitted data to produce multi-dimensional images of the distribution of the tracer throughout the brain.
6. The images help the provider evaluate the metabolism of the tracer as it travels through the brain.

4. Qualifying circumstances

CPT 78608 is performed when a provider needs to evaluate the metabolic activity in a patient’s brain. This procedure is commonly used to assess conditions such as brain tumors, Alzheimer’s disease, epilepsy, and other neurological disorders. The patient must undergo brain imaging using PET for metabolic evaluation, and the provider must use a radioactive tracer or radionuclide to track the distribution of the substance within the brain.

5. When to use CPT code 78608

CPT code 78608 should be used when a provider performs brain imaging using PET for metabolic evaluation. It is appropriate to bill this code when the procedure is necessary to assess the metabolic activity in the patient’s brain. However, it is important to review payer policies and guidelines to ensure proper usage and documentation requirements.

6. Documentation requirements

To support a claim for CPT 78608, the provider must document the following information:

• Reason for the brain imaging using PET for metabolic evaluation
• Details of the radioactive tracer or radionuclide used
• Date and time of the procedure
• Findings and interpretation of the images
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 78608, it is important to follow the appropriate guidelines. If only the physician’s interpretation is being reported, modifier 26 should be appended to the radiology code. If only the technical component is being reported, modifier TC should be appended to the radiology code. However, it is essential 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, modifiers may not be necessary.

8. Historical information

CPT 78608 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates to the code since its addition.

9. Examples

1. A patient with suspected Alzheimer’s disease undergoes brain imaging using PET for metabolic evaluation to assess the metabolic activity in their brain.
2. A provider performs brain imaging using PET for metabolic evaluation on a patient with a brain tumor to evaluate the tumor’s metabolic activity.
3. A patient with epilepsy undergoes brain imaging using PET for metabolic evaluation to assess the metabolic activity in their brain and identify potential seizure triggers.
4. A provider uses brain imaging using PET for metabolic evaluation to evaluate the metabolic activity in the brain of a patient with Parkinson’s disease.
5. A patient with suspected neurodegenerative disorder undergoes brain imaging using PET for metabolic evaluation to assess the metabolic activity in their brain and aid in diagnosis.