How To Use CPT Code 78832

CPT 78832 describes the radiopharmaceutical localization of a tumor, inflammatory process, or distribution of a radiopharmaceutical agent using SPECT with concurrently acquired CT transmission scan for anatomical review, localization, and determination/detection of pathology. 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 78832?

CPT 78832 can be used to describe the radiopharmaceutical localization of a tumor, inflammatory process, or distribution of a radiopharmaceutical agent using SPECT with concurrently acquired CT transmission scan. This code is used when the provider needs to review the anatomy, localize and determine/detect pathology in at least two areas of the body, such as the pelvis and knees or chest and abdomen, using nuclear imaging.

2. Official Description

The official description of CPT code 78832 is: ‘Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days.’

3. Procedure

1. The provider administers a radiopharmaceutical agent (radioactive tracer) to the patient, typically through intravenous administration.
2. The patient undergoes SPECT with concurrently acquired CT transmission scan using a specialized machine.
3. The machine rotates around the patient, taking images of the target areas while the patient is on a table.
4. The CT scanning uses X-rays to image the patient’s anatomy, while the SPECT camera detects the radioactive tracer absorbed by the body.
5. The images are sent to a computer that fuses them and creates 3D images of the body, showing patient anatomy, pathology, and areas of higher tracer absorption.
6. The provider reviews the images, localizes the tumor, inflammatory process, or distribution of the radiopharmaceutical agent, and produces a formal report for the medical record.

4. Qualifying circumstances

CPT 78832 is used when the provider needs to localize a tumor, inflammatory process, or distribution of a radiopharmaceutical agent using SPECT with concurrently acquired CT transmission scan. The procedure requires a minimum of two areas to be imaged, such as the pelvis and knees or chest and abdomen. The code can also be used for separate acquisitions, such as lung ventilation and perfusion scans. The imaging can be performed on a single day or a single area or acquisition over two or more days.

5. When to use CPT code 78832

CPT code 78832 should be used when the provider needs to perform radiopharmaceutical localization using SPECT with concurrently acquired CT transmission scan. It is appropriate when at least two areas of the body need to be imaged, or when separate acquisitions are required. This code should not be used for cerebrospinal fluid studies that require an injection procedure.

6. Documentation requirements

To support a claim for CPT 78832, the provider must document the following information:

• Patient’s diagnosis or reason for the procedure
• Specific areas imaged or separate acquisitions performed
• Date of the procedure
• Start and end time of the imaging
• Details of the radiopharmaceutical agent used
• Review of the images and localization of the tumor, inflammatory process, or distribution of the radiopharmaceutical agent
• Formal report for the medical record

7. Billing guidelines

When billing for CPT 78832, ensure that the procedure meets the requirements of the code, including the use of SPECT with concurrently acquired CT transmission scan and imaging of at least two areas or separate acquisitions. It is important to compare the descriptors to the documentation carefully to ensure accurate reporting. If reporting only the physician’s interpretation or the technical component, the appropriate modifier should be appended to the radiology code. Payer policies may exempt hospitals from appending the modifier TC to the radiology code. It is also important to consider reporting the radiopharmaceutical substance separately if applicable.

8. Historical information

CPT 78832 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes CPT 78832 for the localization of a tumor in the pelvis and knees using SPECT with concurrently acquired CT transmission scan.
2. A provider performs CPT 78832 to determine the distribution of a radiopharmaceutical agent in the chest and abdomen using SPECT with concurrently acquired CT transmission scan.
3. CPT 78832 is used to localize an inflammatory process in the lungs and perform blood pool imaging using SPECT with concurrently acquired CT transmission scan.
4. A patient undergoes CPT 78832 for the localization of a tumor in the head and neck using SPECT with concurrently acquired CT transmission scan.
5. CPT 78832 is performed to determine the distribution of a radiopharmaceutical agent in the brain and perform vascular flow imaging using SPECT with concurrently acquired CT transmission scan.
6. A provider uses CPT 78832 to localize an inflammatory process in the pelvis and perform blood pool imaging using SPECT with concurrently acquired CT transmission scan.
7. CPT 78832 is used to determine the distribution of a radiopharmaceutical agent in the liver and perform vascular flow imaging using SPECT with concurrently acquired CT transmission scan.