Question:
Lymphoscintigraphy for sentinel node localization was performed after the intradermal injection of 2.25 mCi of technetium 99m labeled Tilmanocept (Lymphoseek) at four sites around the lesion located along the right ear. SPECT-CT acquisition of the injection site and lymph node uptake was acquired and fusion was performed.
Would you report both codes 78195 and 78803 or just the 78195?
Answer:
Based on your question, we would not submit either of the two codes you note, as you described a SPECT/CT of a single area.
Per the CPT codebook, SPECT/CT of a single area is defined by CPT code 78830 (maybe you mistyped 78803 instead of 78830, Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, single area (e.g., head, neck, chest, pelvis) or acquisition, single day imaging).
Typically, you would not submit a code for a planar study (here, 78195) and a SPECT (or a SPECT/CT exam) together unless the planar imaging was a whole-body scan.
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