How To Use CPT Code 78708

CPT 78708 describes the imaging morphology of the kidneys, including vascular flow and function, using a single study with pharmacological intervention. 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 78708?

CPT 78708 can be used to describe a kidney scan, which is a nuclear medicine test used to evaluate the structure and function of the kidneys, as well as blood flow to the kidneys. This code specifically includes the use of pharmacological intervention, such as an angiotensin converting enzyme (ACE) inhibitor and/or diuretic, during the imaging study.

2. Official Description

The official description of CPT code 78708 is: ‘Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic).’ This code is part of the Diagnostic Nuclear Medicine Procedures on the Genitourinary System range (78700-78799).

3. Procedure

1. A radionuclide, a radioactive substance, is injected into the patient’s vein.
2. The radionuclide travels through the bloodstream and into the kidneys.
3. As the radionuclide flows through the blood vessels in the kidneys, a gamma camera takes pictures to evaluate the anatomical structure and blood flow.
4. If pharmacological intervention is required, an ACE inhibitor and/or diuretic may be administered to the patient.
5. The ACE inhibitor helps decrease the constriction of blood vessels, which can improve blood flow and aid in the imaging study of vascular flow.
6. The diuretic helps increase urine production, which can aid in the evaluation of kidney function.
7. The imaging study captures the radionuclide as it is excreted into the urine and drains into the bladder.

4. Qualifying circumstances

CPT 78708 is used for patients undergoing a kidney scan with pharmacological intervention. This may include patients with suspected kidney abnormalities, hypertension (high blood pressure), or other conditions that require evaluation of kidney structure, function, and blood flow. The use of an ACE inhibitor and/or diuretic during the imaging study qualifies for this code.

5. When to use CPT code 78708

CPT code 78708 should be used when performing a kidney scan with pharmacological intervention, specifically the use of an ACE inhibitor and/or diuretic. This code is appropriate when evaluating the morphology, vascular flow, and function of the kidneys in a single study.

6. Documentation requirements

To support a claim for CPT 78708, the documentation should include:

• Indication for the kidney scan and the need for pharmacological intervention
• Details of the pharmacological intervention, including the specific ACE inhibitor and/or diuretic used
• Date and time of the imaging study
• Findings of the kidney scan, including any abnormalities or changes in morphology, vascular flow, or function
• Signature of the healthcare professional performing or supervising the procedure

7. Billing guidelines

When billing for CPT 78708, ensure that the kidney scan includes pharmacological intervention with an ACE inhibitor and/or diuretic. Follow the appropriate guidelines for reporting nuclear medicine procedures on the genitourinary system. It is important to note that CPT code 78708 should not be reported if other codes, such as CPT codes 78700-78707, have already been performed in the previous seven days.

8. Historical information

CPT 78708 was added to the Current Procedural Terminology system on January 1, 1998. On January 1, 2007, the code description was changed to include the specific mention of kidney imaging with vascular flow and function.

9. Examples

1. A patient with hypertension undergoes a kidney scan with the administration of an ACE inhibitor to evaluate the vascular flow and function of the kidneys.
2. A patient with suspected kidney abnormalities receives a kidney scan with the use of a diuretic to assess the morphology and function of the kidneys.
3. A patient with both hypertension and suspected kidney abnormalities undergoes a kidney scan with the administration of both an ACE inhibitor and a diuretic to evaluate the vascular flow, function, and morphology of the kidneys.
4. A patient with a history of kidney disease undergoes a kidney scan with the use of an ACE inhibitor and a diuretic to monitor the progression of the disease and assess the vascular flow and function of the kidneys.
5. A patient with uncontrolled hypertension receives a kidney scan with the administration of an ACE inhibitor and a diuretic to evaluate the effectiveness of the medication in improving vascular flow and function.
6. A patient with a kidney transplant undergoes a kidney scan with the use of an ACE inhibitor and a diuretic to assess the function and blood flow of the transplanted kidney.
7. A patient with suspected renal artery stenosis receives a kidney scan with the administration of an ACE inhibitor to evaluate the vascular flow and function of the kidneys and identify any potential blockages.
8. A patient with recurrent urinary tract infections undergoes a kidney scan with the use of a diuretic to assess the morphology and function of the kidneys and identify any underlying abnormalities.
9. A patient with a family history of kidney disease receives a kidney scan with the administration of an ACE inhibitor and a diuretic to evaluate the vascular flow, function, and morphology of the kidneys as a preventive measure.
10. A patient with chronic kidney disease undergoes a kidney scan with the use of an ACE inhibitor and a diuretic to monitor the progression of the disease and assess the vascular flow and function of the kidneys.