2025 CPT code 79101
Effective Date: N/A Radiology - Nuclear Medicine Feed
Radiopharmaceutical therapy, by intravenous administration.
Modifiers 26 (professional component), TC (technical component), 52 (reduced services), 76, 77, 79, 80, 81, 82, 99, AQ, AS, GC, GR, KX, PD, and Q6 can be applied when appropriate.
Medical necessity must be established for the use of radiopharmaceutical therapy. Documentation should support the medical rationale for this treatment approach.
Administering the radiopharmaceutical intravenously. The physician is also responsible for the patient's overall care, including diagnosis, treatment planning, and follow-up.
In simple words: This procedure involves injecting a radioactive material into your vein to treat a medical condition, usually cancer. The substance travels throughout your body to target and destroy affected cells. The cost of the radioactive material itself is billed separately.
This code represents the intravenous administration of a radiopharmaceutical for therapeutic purposes. It does not include the supply of the radiopharmaceutical itself, which should be billed separately. The code also excludes any related diagnostic workup, follow-up care, or procedures like intra-arterial administration, which require additional coding.
Example 1: A patient with thyroid cancer receives radioactive iodine (I-131) intravenously to destroy cancerous thyroid cells., A patient with bone pain due to metastatic prostate cancer receives Samarium-153 intravenously for pain palliation., A patient with non-Hodgkin's lymphoma receives radioactive Yttrium-90-labeled antibodies intravenously as part of their treatment.
Documentation should include the type and dose of radiopharmaceutical administered, the route of administration, the diagnosis being treated, and any pre- and post-administration care provided.
- Revenue Code: O1E - OTHER DRUGS
- Modifier TC rule: Modifier TC can be used to indicate that only the technical component of the service was provided.
- Specialties:Nuclear Medicine, Radiation Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Independent Clinic