Coding for SPECT-CT imaging of the head and neck and upper thorax

Q.

Our provider performed an injection for sentinel node location from a melanoma of the scalp but then did lymphatic imaging of the head, neck, and chest. I am not sure if it would be correct to submit both CPT codes, 78195 and 78832, 78195 and 78830 or just the solitary code of 78195.

A.

When you do limited-area planar (static) imaging (in this case 78195) with SPECT or SPECT/CT, you bill only the appropriate SPECT or SPECT/CT CPT code. 

In this case, because they did SPECT-CT imaging of the head and neck and upper thorax, you would report CPT code 78832.

The code and full description are:

78832   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, minimum 2 areas (e.g., pelvis and knees, abdomen and pelvis), single day imaging, or single area imaging over 2 or more days