Radiology Coding Alert

Question: Our radiologist performed the following procedure: 11 millicuries gallium-67 citrate administered. Images obtained at 48 and 72 hours. Bowel preparation between those two evaluations. No persistent focal abnormal activity on this evaluation to suggest lymphomatous involvement. Some bowel activity is noted in different locations on the two examinations. Should I code scans at 48 hours and at 72 hours, or would a single code include all of the scans?

Rhode Island Subscriber

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  Answer: It would not be appropriate to bill the described procedure twice. Gallium-67 is used for nuclear medicine services described in codes 78800-78807, which are reported for tumor localization and localization of inflammatory process. Although CPT Codes does not specifically address delayed imaging in its definition, coders should report multiple evaluations as a single service. Some local Medicare review policies, however, do mention that nuclear medicine tests often take two or three days and that only one code should be reported for the complete service.