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Bone and/or joint imaging using scintigraphy is a diagnostic procedure that employs a radiolabeled isotope tracer to visualize skeletal structures. This imaging technique is particularly useful for patients experiencing unexplained skeletal pain that may indicate underlying conditions such as bone loss, infection, inflammation, or injury. Traditional radiographic methods, such as planar X-rays, may not always yield a definitive diagnosis, making scintigraphy a valuable alternative. The process begins with the establishment of an intravenous line, through which the radiolabeled isotope tracer is injected into the patient's circulatory system. In cases where inflammation is suspected, a blood sample is collected and processed to isolate white blood cells (WBCs), which are then tagged with radioactive calcium and reintroduced into the patient. Following a designated waiting period, the patient is positioned on an imaging table, and a gamma camera is used to capture images of the targeted areas. For imaging of multiple areas, the specific CPT® code 78305 is utilized, while limited area scans and full-body scans are reported with codes 78300 and 78306, respectively. The emitted radioactive energy is transformed into images that the physician interprets, culminating in a comprehensive written report detailing the findings of the bone and/or joint imaging study.
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Bone and/or joint imaging using scintigraphy is indicated for patients presenting with specific symptoms or conditions that warrant further investigation. The following indications are explicitly recognized for this procedure:
The procedure for bone and/or joint imaging using scintigraphy involves several critical steps to ensure accurate results. The following procedural steps are outlined:
After the completion of the bone and/or joint imaging procedure, patients may be monitored briefly to ensure there are no immediate adverse reactions to the radiolabeled isotope tracer. There are typically no specific post-procedure care requirements, and patients can usually resume 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 tracer used. The physician will review the imaging results and discuss the findings with the patient, which may lead to further diagnostic or therapeutic interventions based on the outcomes of the study.
| Short Descr | BONE IMAGING MULTIPLE AREAS | Medium Descr | BONE &/JOINT IMAGING MULTIPLE AREAS | Long Descr | Bone and/or joint imaging; multiple areas | 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 | 207 - Radioisotope bone scan |
| 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 | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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 | 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 | 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 | 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 | 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 | 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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