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Parathyroid planar imaging is a diagnostic imaging procedure that involves the use of a radiopharmaceutical, specifically technetium-99m (TC-99) sestamibi, which is administered intravenously. This imaging technique is primarily utilized to assess the parathyroid glands, which are responsible for regulating calcium levels in the body. The procedure begins with the acquisition of initial planar images shortly after the radiopharmaceutical is injected. These images are crucial for evaluating any increased uptake of the radiotracer in the parathyroid tissue compared to the thyroid tissue, as abnormal uptake can indicate parathyroid disease. Following this, additional images are captured approximately two hours later to determine if there is any retention of the radiotracer in the parathyroid glands, which can further assist in diagnosing conditions such as hyperparathyroidism. In cases where subtraction studies are indicated, a second radiopharmaceutical that is selectively taken up by the thyroid gland, such as iodine-123 (I-123) or technetium-99m pertechnetate, is administered. This allows for the generation of subtraction images that can enhance the visualization of the parathyroid glands. Recent advancements in this imaging modality have integrated single photon emission computed tomography (SPECT) with parathyroid planar imaging, allowing for a more comprehensive evaluation by combining both functional and anatomical information. This integration significantly improves the sensitivity of detecting parathyroid abnormalities. It is important to note that CPT® code 78070 is designated for parathyroid planar imaging performed alone, while CPT® code 78071 is specifically used when this imaging is combined with tomographic (SPECT) studies. Additionally, CPT® code 78072 is applicable when planar imaging, tomographic (SPECT) studies, and concurrent CT imaging for anatomical localization are all performed together.
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The indications for parathyroid planar imaging with tomographic (SPECT) studies include the following:
The procedure for parathyroid planar imaging with tomographic (SPECT) studies involves several key steps:
After the completion of parathyroid planar imaging with tomographic (SPECT) studies, patients may be monitored briefly to ensure there are no immediate adverse reactions to the radiopharmaceutical. There are typically no specific post-procedure care requirements, and patients can usually resume normal activities immediately. However, it is advisable for patients to stay hydrated and follow any additional instructions provided by the healthcare provider. The results of the imaging studies will be interpreted by a qualified physician, who will discuss the findings and any necessary follow-up actions with the patient.
| Short Descr | PARATHYRD PLANAR W/WO SUBTRJ | Medium Descr | PARATHYROID PLANAR IMAGING W/WO SUBTRACTION | Long Descr | Parathyroid planar imaging (including subtraction, when performed); with tomographic (SPECT) | 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) | I1F - Standard imaging - other | MUE | 1 | CCS Clinical Classification | 209 - Radioisotope scan and function studies |
| 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 | 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 | 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 | 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 | 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 | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | LT | Left side (used to identify procedures performed on the left side of the body) | MA | Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition | 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 | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional |
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