Nuclear Medicine Question for the Week of December 14, 2015

Question:

Question 

Sometimes the radiopharmaceutical is injected for intra-operative use (breast cancer surgery/parathyroid surgery). Is there a special way to code these situations? In these instances, the patient is just being injected and never scanned.

Answer

You should consider two codes. For the breast cancer surgery, you are probably doing a sentinel node injection. If no images are taken, then the following code is used for the injection: 

38792Injection procedure; radioactive tracer for identification of sentinel node

If images are taken, do not assign 37892. Assign instead the following code: 

78195Lymphatics and lymph nodes imaging

In other cases, particularly parathyroid, where you are injecting a radiopharmaceutical and sending the patient to surgery without imaging, assign the following code:

78808Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (e.g., parathyroid adenoma) 

You would also assign the appropriate A-code for the radiopharmaceutical used.  

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