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Radiology Coding Alert

Reader Question:

Avoid Myocardial Codes for Extremities

Question: I performed a thallium scan of the lower extremity with SPECT and planar images to rule out compartment syndrome. Should I report 78465 for this study?

Tennessee Subscriber

Answer: You can report 78465 (Myocardial perfusion imaging; tomographic [SPECT], multiple studies, at rest and/or stress [exercise and/or pharmacologic] and redistribution and/or rest injection, with or without quantification) only if you address the cardiovascular system. Your lower-extremity SPECT study would not meet the requirements to report 78465, so you should instead opt for 78399 (Unlisted musculoskeletal procedure, diagnostic nuclear medicine). 

As with all unlisted-procedure codes, you should submit the procedure note to the insurer with your claim, along with a short letter explaining what you performed and why it was medically necessary.

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