2025 CPT code 78305
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diagnostic Imaging - Nuclear Medicine Procedures Radiology Feed
Bone and/or joint imaging of multiple areas using radionuclides.
Modifiers 26 (professional component) and TC (technical component) are applicable depending on whether the physician performs only the interpretation or both the interpretation and technical aspects.Other modifiers may apply depending on specific circumstances, as per the current CPT guidelines.
Medical necessity for a bone scan (78305) is established by clinical findings suggestive of bone pathology, such as unexplained bone pain, suspected fractures, history of cancer, or suspected osteomyelitis.The referring physician must document the clinical indications clearly to ensure coverage by the payer.
The physician is responsible for administering the radionuclide intravenously, monitoring the patient, acquiring and interpreting the images, and generating the report of findings.Depending on the setting, other personnel may assist with the technical aspects of imaging.
In simple words: This test uses a special dye containing a tiny amount of radioactivity to take pictures of your bones and joints.A doctor injects the dye into your vein, and after a few hours, they take pictures to check for problems like broken bones or infections. The pictures focus on specific areas of your body, not your whole body.
This CPT code, 78305, represents a diagnostic nuclear medicine procedure involving bone and/or joint imaging across multiple skeletal areas.A radionuclide (radioactive tracer) is administered intravenously, followed by imaging after a waiting period (typically 4-6 hours) to visualize and assess bone structures for abnormalities. The imaging focuses on several, but not all, areas of the skeleton (e.g., bilateral ankles and knees, both hands and wrists, or lower spine and pelvis). The procedure aids in diagnosing conditions such as fractures, osteomyelitis, or metastatic bone disease.The radiopharmaceutical is not included in this code and should be billed separately if applicable.
Example 1: A patient presents with persistent lower back pain and suspected metastatic bone disease. A bone scan (78305) is ordered to assess the extent of potential bone metastases., A patient sustains a high-energy trauma to the lower extremity.A bone scan (78305) is ordered to evaluate for occult fractures not readily apparent on initial x-rays., A patient with a history of osteomyelitis undergoes a bone scan (78305) to monitor the response to antibiotic treatment and to detect any new areas of infection.
* Patient history including chief complaint and relevant medical history.* Indication for the bone scan.* Details of the radionuclide administered (type, dosage).* Imaging protocol used.* Images themselves.* Radiologist's interpretation and report, including specific findings and measurements.
** Always ensure that billing practices are compliant with current coding guidelines and payer policies.The use of modifiers and the separate billing of radiopharmaceuticals should be thoroughly understood to ensure proper reimbursement.
- Revenue Code: I1E (Standard Imaging - Nuclear Medicine)
- RVU: RVUs will vary depending on location, payer, and other factors. Consult your local fee schedule or payer guidelines.
- Global Days: Not applicable. This is not a global procedure with a defined postoperative period.
- Payment Status: Active
- Modifier TC rule: Modifier TC (technical component) is applicable if only the technical component of the bone scan is performed by the facility. In a hospital setting, the hospital typically bills for the technical component, so modifier TC may be unnecessary or not allowed.
- Fee Schedule: Fee schedules vary by payer and geographic location.Check your local payer's fee schedule for historical and current reimbursement rates.
- Specialties:Nuclear Medicine, Radiology, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Nuclear Medicine Clinic, Other Place of Service