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The CPT® Code 78018 refers to a nuclear medicine imaging study specifically designed to assess the presence and extent of metastatic disease related to thyroid carcinoma throughout the entire body. This procedure involves the administration of radioactive iodine isotopes, commonly known as radioactive tracers, which can be given either orally in liquid or capsule form or intravenously. The method of administration dictates the timing of the imaging procedure; if the tracer is taken orally, imaging occurs several hours to 24 hours later, allowing sufficient time for the tracer to circulate and localize in areas of potential metastasis. Conversely, if the tracer is administered intravenously, imaging is conducted approximately 30 minutes post-administration, as the tracer is expected to be more rapidly distributed throughout the body. During the imaging process, the radioactive isotopes emit gamma rays, which are captured by a gamma camera. This camera, in conjunction with computer processing, generates images that are displayed on a computer screen for analysis. The procedure is comprehensive, as it encompasses a whole-body survey, unlike related codes such as 78015, which focuses on limited regions like the neck and chest. In the whole-body scan, the patient is positioned supine on the examination table for the initial scan of the front body, followed by a prone position to scan the back. The resulting images provide critical information regarding the distribution of metastatic sites, which is essential for the physician's evaluation and subsequent reporting of findings.
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The procedure associated with CPT® Code 78018 is indicated for the evaluation of thyroid carcinoma metastases. It is performed to identify the site(s) and extent of metastatic disease in patients diagnosed with thyroid cancer. The imaging study is crucial for determining the progression of the disease and guiding further treatment decisions.
The procedure for CPT® Code 78018 involves several key steps to ensure accurate imaging of thyroid carcinoma metastases. Initially, the patient is prepared for the administration of radioactive iodine isotopes. These isotopes can be given orally, either as a liquid or in capsule form, or intravenously. If administered orally, the patient must wait several hours to up to 24 hours before the imaging procedure begins, allowing the tracer to adequately circulate and localize in potential metastatic sites. In cases where the tracer is given intravenously, the imaging can commence approximately 30 minutes after administration, as the tracer is expected to distribute more rapidly through the bloodstream. Once the appropriate waiting period has elapsed, the patient is positioned on the examination table. The imaging process begins with the patient lying supine, allowing the gamma camera to scan the front of the body. This initial scan captures images of the anterior aspects where metastases may be present. After completing the front scan, the patient is then instructed to lie prone on the examination table. This position enables the gamma camera to perform a thorough scan of the posterior aspects of the body. Throughout the procedure, the gamma camera detects the gamma rays emitted by the radioactive isotopes, and these signals are processed by a computer to create detailed images of the body. The resulting images are displayed on a computer screen for review by the physician, who will analyze the findings and generate a written report summarizing the results of the whole-body metastatic survey.
After the completion of the imaging procedure associated with CPT® Code 78018, the patient may be monitored briefly to ensure there are no immediate adverse reactions to the radioactive tracer. There are typically no specific post-procedure care requirements, and patients can usually resume their normal activities shortly after the imaging is completed. However, it is essential for patients to follow any specific instructions provided by the healthcare provider regarding hydration or any other considerations related to the radioactive material used during the procedure. The physician will review the images obtained during the scan and prepare a comprehensive report detailing the findings, which will be communicated to the patient and used to inform further management of their thyroid carcinoma.
| Short Descr | THYROID MET IMAGING BODY | Medium Descr | THYROID CARCINOMA METASTASES IMG WHOLE BODY | Long Descr | Thyroid carcinoma metastases imaging; whole body | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I1E - Standard imaging - nuclear medicine | MUE | 1 | CCS Clinical Classification | 209 - Radioisotope scan and function studies |
This is a primary code that can be used with these additional add-on codes.
| 78020 | Addon Code MPFS Status: Active Code APC N ASC N1 PUB 100 CPT Assistant Article Thyroid carcinoma metastases uptake (List separately in addition to code for primary procedure) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | GC | This service has been performed in part by a resident under the direction of a teaching physician | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | MB | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access | MC | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | MF | The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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