For the CPT 2023 code set, four codes (78803, 78830-78832) were revised to further explain the use and intent of these codes. These revisions distinguish between a single area or a single acquisition vs two or more separate acquisitions with two radiopharmaceuticals that are performed on the same date of service or over two or more days. The intent and use of these codes remain the same. This article provides an overview of the editorial revisions.

Nuclear Medicine CPT codes

 78800 Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging

(For specific organ, see appropriate heading)

Δ78803 tomographic (SPECT), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging

(For imaging bone infectious or inflammatory disease with a bone imaging radiopharmaceutical, see 78300, 78305, 78306, 78315)

Δ78830 tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging

Δ78831 tomographic (SPECT), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days

Δ78832  tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days

(For cerebrospinal fluid studies that require injection procedure, see 61055, 61070, 62320, 62321, 62322, 62323)

Prior to 2023, codes 78803 and 78830-78832 were not differentiated according to acquisition; instead, they were differentiated according to the anatomic area imaged and/or whether single-day or multiple-day imaging was performed. Adding “or acquisition” to the code descriptors of these four codes enables more specific reporting (ie, according to anatomic area or acquisition performed) while maintaining uniformity in the code family. The term “acquisition” for nuclear medicine services and procedures is also referred to as “a scan.” Note that the size of the gamma camera head essentially defines the field of view (FOV) or the area that the camera can image. While camera heads and patients vary in size, there are FOVs (or acquisition fields) in nuclear medicine that are commonly considered a single area or multiple areas of acquisitions.

An acquisition is a scan consisting of static or dynamic planar images, which are acquired with the gamma camera (or scintillation camera) in a fixed position for the duration of imaging. In single-photon emission computed tomography (SPECT) imaging, a series of images is acquired as the gamma camera rotates around a defined area of the patient. These images are then reconstructed to form a three-dimensional dataset from which coronal, sagittal, and transverse slices through the body can be reconstructed, similar to CT exams.

Note that repeat imaging is not always considered a separate acquisition (eg, a scan repeated due to patient motion). For a SPECT study, any planar or “spot” imaging of an area that was imaged by SPECT is not separately reported and is included in the SPECT or SPECT-CT study. A separate acquisition should be distinctly different, such as the next-day or time-delayed imaging, a different or separate area  or a different radiotracer (eg, lung ventilation and perfusion imaging).