How To Use CPT Code 78835

CPT 78835 describes the measurement of radiopharmaceutical quantification in a single area, in addition to the primary procedure. 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 78835?

CPT 78835 can be used to describe the measurement of radiopharmaceutical quantification in a single area, when performed alongside a primary procedure. This code is used when the provider assesses the amount of a radiopharmaceutical agent in a specific area, rather than simply evaluating its distribution.

2. Official Description

The official description of CPT code 78835 is: ‘Radiopharmaceutical quantification measurement(s) single area (List separately in addition to code for primary procedure).’ This code should be used in conjunction with the appropriate primary procedure code.

3. Procedure

1. During the performance of a nuclear imaging procedure, the provider measures the amount of a radiopharmaceutical agent in a specific area.

4. Qualifying circumstances

CPT 78835 is used when the provider quantifies the amount of a radiopharmaceutical agent in a single area, in addition to the primary procedure. This code should be reported when the measurement of the radiopharmaceutical is necessary for the evaluation and management of the patient’s condition.

5. When to use CPT code 78835

CPT code 78835 should be used when the provider needs to measure the amount of a radiopharmaceutical agent in a specific area, in addition to performing a primary procedure. It is important to note that this code should not be reported if the provider is only assessing the distribution of the radiopharmaceutical without quantification.

6. Documentation requirements

To support a claim for CPT 78835, the provider must document the following information:

• The primary procedure performed
• The specific area in which the radiopharmaceutical quantification was measured
• The date and time of the procedure
• The amount of the radiopharmaceutical agent measured
• Any additional relevant information related to the measurement

7. Billing guidelines

When billing for CPT 78835, ensure that the measurement of the radiopharmaceutical quantification is performed in addition to a primary procedure. It is important to use the appropriate primary procedure code and report CPT 78835 separately. If the radiopharmaceutical agent is supplied separately, the entity responsible for the cost should report the supply using the appropriate code. Modifier 26 should be appended if reporting only the physician’s interpretation, and modifier TC should be appended if reporting only the technical component. However, it is important to review payer policies regarding the use of these modifiers.

8. Historical information

CPT 78835 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A provider measures the amount of a radiopharmaceutical agent in a specific area during a bone scan for a patient with suspected bone metastasis.
2. During a thyroid scan, the provider quantifies the amount of a radiopharmaceutical agent in the thyroid gland to assess its function.
3. For a patient undergoing tumor imaging, the provider measures the amount of a radiopharmaceutical agent in a specific area to determine the extent of the tumor.
4. During a lung scan, the provider quantifies the amount of a radiopharmaceutical agent in a specific area to evaluate pulmonary function.
5. For a patient with suspected parathyroid disease, the provider measures the amount of a radiopharmaceutical agent in the parathyroid gland to assess its function.