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BETA v.3.0

2025 CPT code 78802

Radiopharmaceutical localization of tumor, inflammatory process, or distribution of radiopharmaceutical agent(s), including vascular flow and blood pool imaging when performed; planar, whole body, single-day imaging.

Modifiers 26 (Professional Component) and TC (Technical Component) can be used when appropriate. Refer to current CPT coding guidelines for correct application.

Modifiers 26, TC, 51, 52, 53, 59, 76, 77, and others may apply depending on the circumstances. Modifier 26 is used for professional component only, TC for technical component only. Check individual payer policies for applicable modifiers.

Medical necessity must be established for each patient.The documentation should clearly demonstrate the clinical rationale for performing the procedure, linking it to the patient's signs, symptoms, and medical history.

The physician administers the radiopharmaceutical, supervises the imaging process, interprets the images, and formulates a diagnosis.

IMPORTANT:78803 (SPECT, single area), 78804 (whole body, 2 or more days)

In simple words: This is a nuclear medicine scan that uses a small amount of radioactive material to create images of the whole body. It helps doctors find tumors, inflammation, or track how special drugs move through your system.It can also show how blood flows through your heart and lungs.

This procedure involves the use of radiopharmaceuticals to locate tumors or inflammatory processes or to track the distribution of radiopharmaceutical agents within the body.It includes vascular flow and blood pool imaging, if performed. The imaging is performed using planar imaging techniques, covering the whole body in a single day.

Example 1: A patient with suspected metastatic melanoma undergoes a whole-body planar scan using a radiolabeled monoclonal antibody to identify the location of metastatic lesions., A patient with Crohn's disease undergoes a whole-body planar scan using a radiolabeled white blood cell study to evaluate the extent and activity of bowel inflammation., A patient with a history of lymphoma undergoes a whole-body planar scan to assess treatment response.

Documentation should include the reason for the scan, the radiopharmaceutical used, the dosage, the imaging technique employed, the physician's interpretation of the images, and the diagnosis.

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