How To Use CPT Code 79005

CPT 79005 describes the administration of radiopharmaceutical therapy by oral administration. 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 79005?

CPT 79005 can be used to describe the administration of radiopharmaceutical therapy by oral administration. This code is used when a provider administers a radiopharmaceutical substance orally to treat cancer or other conditions. The goal of this therapy is to treat various metabolic diseases and cancers by using radioactive materials.

2. Official Description

The official description of CPT code 79005 is: ‘Radiopharmaceutical therapy, by oral administration.’

3. Procedure

1. In this procedure, the provider administers a radiopharmaceutical substance orally to treat cancer or other conditions.

4. Qualifying circumstances

Patients eligible to receive CPT 79005 are those who require radiopharmaceutical therapy for the treatment of cancer or other conditions. The provider administers the radiopharmaceutical substance orally, emitting ionizing radiation that travels a short distance to minimize side effects and damage to non-involved organs or nearby structures.

5. When to use CPT code 79005

CPT code 79005 should be used when a provider administers radiopharmaceutical therapy by oral administration. It is appropriate for the treatment of cancer or other conditions that require this type of therapy.

6. Documentation requirements

To support a claim for CPT 79005, the provider must document the following information:

• Patient’s diagnosis and the need for radiopharmaceutical therapy
• Details of the radiopharmaceutical substance administered
• Date and time of the administration
• Any additional relevant information related to the procedure

7. Billing guidelines

When billing for CPT 79005, ensure that the provider administers the radiopharmaceutical therapy by oral administration. Report the radiopharmaceutical substance separately if necessary. Use the appropriate modifiers if reporting only the professional or technical component of the radiology service. Be aware of payer policies regarding modifier usage.

8. Historical information

CPT 79005 was added to the Current Procedural Terminology system on January 1, 2005. There have been no updates to the code since its addition.

9. Examples

1. A provider administers an oral radiopharmaceutical substance to a patient with thyroid cancer.
2. A patient receives radiopharmaceutical therapy by oral administration for the treatment of a metabolic disease.
3. A provider administers an oral radiopharmaceutical substance to a patient with liver cancer.
4. A patient undergoes radiopharmaceutical therapy by oral administration for the treatment of bone metastases.
5. A provider administers an oral radiopharmaceutical substance to a patient with neuroendocrine tumors.
6. A patient receives radiopharmaceutical therapy by oral administration for the treatment of lymphoma.
7. A provider administers an oral radiopharmaceutical substance to a patient with prostate cancer.
8. A patient undergoes radiopharmaceutical therapy by oral administration for the treatment of lung cancer.
9. A provider administers an oral radiopharmaceutical substance to a patient with breast cancer.
10. A patient receives radiopharmaceutical therapy by oral administration for the treatment of gastrointestinal stromal tumors.