Nuclear Medicine Question for the Week of April 25, 2016


Can we assign codes 78630 and 78647 together?


These two codes are bundled, so you can code only one. 

78630Cerebrospinal fluid flow (CSF), imaging (not including introduction of material); cisternography 

78647 tomographic (SPECT) 

Remember: The general rule in nuclear medicine is that a SPECT study includes limited planar imaging. You can only code both a planar and SPECT study together when the planar exam is whole body. Since a cisternogram is a limited area scan, you cannot code both the cisternogram and CSF SPECT. 

There are national correct coding initiative (CCI) edits that preclude coding 78647 with 78630, and the edit cannot be bypassed.