Can we report 78802 with 78830 if a single whole-body study and a single area SPECT or SPECT/CT are performed on the same date of service?
When a single whole body study and a single area SPECT or SPECT/CT are performed on the same date of service, you may report both 78802 (or other organ-specific whole body CPT codes) with 78803 or 78830; modifier 51 is appended to the lower RVU code. This will result in payment of 100% of the higher priced service and 50% of the lower priced service and is necessary to account for overlap in the payment rates (Modifier 51 is not assigned by hospitals billing under OPPS).
This question was answered in our Nuclear Medicine & PET Coder. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.
CPT® copyright 2024 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
Copyright © 2025 RACmonitor. Powered by MedLearn Media.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24