Question of the WeekRadiology

Radiology Question for the Week of October 9, 2017

Question:

How would you code the following bone scan study?

“Findings: a focus of increased uptake in the medial left clavicle corresponding with fracture seen on CT. Anterior rib uptake bilaterally is probably due to accidental trauma and similar-appearing Steele bone scan. Right posterior 11th rib lesion is without obvious change. Hip prostheses noted. No definite new bone metastases.  Conclusion: the lesion is in the left medial clavicle corresponds to benign appearing fracture on CT. Stable right posterior 11th rib lesion.”

Answer:

Unless the patient was small, you would probably assign code 78305 (bone and/or joint imaging; multiple areas). The doctor does say, “No definite new bone metastases” but does not indicate that the whole skeleton was imaged for a whole body scan.

If all of this (clavicle to hip) can be seen in one field of view then it would be limited (78300), but if the camera had to be moved to image all of that area, it would be multiple areas.