2025 CPT code 78306
(Active) Effective Date: N/A Revision Date: N/A Radiology Procedures - Nuclear Medicine Procedures Radiology Feed
Bone and/or joint imaging; whole body.
Modifiers 26 (professional component only) and TC (technical component only) may be appended as appropriate, depending on the services performed and payer policies.Modifier 59 (distinct procedural service) may be used if the bone scan is performed as a separate and distinct procedure from other imaging.
Medical necessity for a bone scan is typically established by the presence of symptoms or findings suggestive of bone pathology, such as persistent bone pain, elevated bone-specific markers (e.g., alkaline phosphatase), or a history of cancer with a high risk of bone metastasis.
The physician is responsible for injecting the radionuclide, waiting the appropriate time, and acquiring and interpreting the images of the bones and joints.The physician may also be responsible for any necessary follow-up care related to the findings.
In simple words: A bone scan is a special test where a tiny amount of radioactive material is injected into a vein.After a few hours, pictures are taken of your entire body to check your bones for problems like fractures, infections, or cancer that has spread to the bones.
This CPT code (78306) represents a whole-body bone scan, also known as scintigraphy.The procedure involves intravenous injection of a radionuclide tracer, followed by imaging of the entire skeleton after a waiting period (typically 4-6 hours) to assess bone and joint structures for fractures, osteomyelitis, or metastatic disease. The report includes the images and physician's interpretation.The supply of the radiopharmaceutical is billed separately.
Example 1: A 60-year-old male presents with persistent back pain and elevated alkaline phosphatase levels.A bone scan is ordered to evaluate for the presence of metastatic bone disease from a previously diagnosed prostate cancer., A 25-year-old female sustained a fall and complains of persistent pain in her right ankle. A bone scan is ordered to assess for a possible occult fracture., A 70-year-old male with a history of diabetes mellitus is experiencing leg pain and swelling. A bone scan is ordered to rule out osteomyelitis.
* Patient history and physical examination findings documenting the clinical indication for the bone scan.* Imaging reports (including images) with interpretation by the physician.* Documentation of the type and amount of radionuclide used.* Documentation of the time interval between injection and imaging.
** The radiopharmaceutical used in the bone scan should be documented.The interpretation of the scan should be comprehensive and should include the findings and their clinical correlation.
- Revenue Code: I1E (STANDARD IMAGING - NUCLEAR MEDICINE)
- Payment Status: Active
- Modifier TC rule: Modifier TC may apply for the technical component when billed separately.
- Specialties:Nuclear Medicine, Radiology, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Office