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CPT 78020: Thyroid Scan, Nuclear Medicine

CPT code 78020 denotes a thyroid scan, a nuclear medicine imaging study that uses a radionuclide tracer to assess thyroid gland function, identify nodules, and, when indicated, evaluate for metastatic disease in patients with thyroid cancer. Nationally, this exam is an important tool in endocrine and oncology diagnostic pathways, informing decisions about further imaging, biopsy, and therapeutic planning.

Key payers included in the coverage and benchmarking discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications and expected sites of service, typical payer considerations, common billing modifiers, and related coding context where available. The publication also summarizes benchmarking and policy-relevant topics such as utilization patterns, prior authorization practices, and coding compliance considerations tied to nuclear medicine thyroid imaging.

This summary provides clinicians, coders, and policy analysts with a concise reference to the clinical purpose of CPT code 78020, the typical delivery settings, and the payer landscape impacting access and reimbursement. Data not available in the input is identified where applicable.

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Billing Code Overview

CPT code 78020 describes a thyroid scan, a nuclear medicine diagnostic procedure that uses a radionuclide tracer to evaluate thyroid gland function and to detect thyroid nodules. The scan can also be performed as a whole-body thyroid scan for surveillance in patients with a history of thyroid cancer to assess for metastatic spread.

Service type: Nuclear medicine diagnostic imaging

Typical site of service: Hospital outpatient imaging departments, freestanding nuclear medicine or radiology centers, and outpatient clinics with nuclear medicine capability

Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.

Find policies, billing codes, payers, states, and providers

CPT 78020: Thyroid Scan, Nuclear Medicine

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Sign up for cpt 78020 policy alerts

Get alerted when payer policies referencing 78020 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Nuclear medicine diagnostic imaging

Typical site of service: Hospital outpatient imaging departments, freestanding nuclear medicine or radiology centers, and outpatient clinics with nuclear medicine capability

Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.

Clinical & Coding Specifications

Clinical Context

A 52-year-old patient with a history of differentiated thyroid cancer after total thyroidectomy presents for surveillance. The patient is referred by an endocrinologist for a nuclear medicine thyroid scan using a radionuclide tracer to evaluate residual thyroid tissue and to detect metastatic uptake in the neck or distant sites. The clinical workflow begins with referral and prior authorization if required by the payer, scheduling with fasting or medication-holding instructions as appropriate, and obtaining informed consent. On the day of service, a nuclear medicine technologist administers the radiotracer (commonly 123I or 99mTc-pertechnetate), and images are acquired with a gamma camera; imaging may include dedicated thyroid views or a whole-body scan if indicated. The interpreting nuclear medicine physician or radiologist documents the technique, radiopharmaceutical and dose, imaging times, findings regarding gland uptake or focal nodules, and comparison to prior studies; a report is routed to the referring endocrinologist or surgeon for clinical management decisions.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician interpretation/report for the thyroid scan separate from technical services
`TC`	Technical component	When billing only the imaging/technical component (camera, technologist, radiopharmaceutical)
`50`	Bilateral procedure	Rarely applicable; use when a procedure has distinct bilateral reporting requirements (generally not used for thyroid scan imaging)
`52`	Reduced services	When the study is partially completed or limited compared with standard protocol
`53`	Discontinued procedure	When the scan is started but halted for patient safety reasons
`59`	Distinct procedural service	When a separate, unrelated procedure is performed on the same day requiring separate reporting
`76`	Repeat procedure by same physician	Use when the same physician repeats the scan within the postoperative or relevant timeframe (not in raw list; omit if strict compliance required)
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use only if a related interventional procedure occurs (rare for imaging)
`22`	Increased procedural services	When the interpretation requires significantly greater effort or complexity than typical
`27`	Multiple outpatient hospital settings	Use when services are provided across multiple outpatient settings on the same date
`51`	Multiple procedures	When multiple radiology/nuclear medicine procedures are performed and payers require modifier for secondary procedures
`52`	Reduced services	When the full imaging protocol cannot be completed (duplicate entry — see above)
`QX`	Modifier indicating that the assistant at surgery is a qualified resident	Generally not applicable to imaging services but listed in raw modifiers

Taxonomy Code	Specialty	Notes
2085P0202X	Nuclear Medicine Physician	Interprets and reports radionuclide thyroid studies
207R00000X	Radiologist	Performs and interprets nuclear medicine imaging in many institutions
207L00000X	Diagnostic Radiology	Radiologists with diagnostic focus who may interpret thyroid scans
207K00000X	Endocrinology (consulting)	Refers patients and uses results for clinical management
2084P0800X	General Surgery (head & neck)	Uses scan results for surgical planning or surveillance

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E06.3`	Autoimmune thyroiditis	May present with abnormal uptake patterns prompting thyroid scan
`E03.9`	Hypothyroidism, unspecified	Scans may be used to evaluate residual tissue or ectopic uptake in complex cases
`E04.1`	Nontoxic single thyroid nodule	Localizes functioning versus nonfunctioning nodules
`C73`	Malignant neoplasm of thyroid gland	Post-thyroidectomy surveillance often includes whole-body or neck scans to detect residual or metastatic disease
`E05.90`	Thyrotoxicosis, unspecified without thyrotoxic crisis or storm	Thyroid scan helps differentiate causes of hyperthyroidism (e.g., Graves vs toxic nodule)

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`78020`	Thyroid uptake and imaging (static or dynamic), planar or SPECT	Primary CPT for radionuclide thyroid imaging to assess thyroid function and nodules
`78100`	Thyroid uptake (single quantitative determination)	Often performed in conjunction to quantify radionuclide uptake prior to or alongside imaging
`78800`	SPECT study without qualifying CT	May be performed if tomographic nuclear imaging of the neck is required for improved localization
`79005`	Radiopharmaceutical therapy or complex therapeutic nuclear medicine administration — (note: specific codes vary)	Related when a diagnostic scan leads to therapeutic radioactive iodine planning (use institution-specific therapy codes)
`88305`	Surgical pathology, gross and microscopic examination	May be related when focal uptake leads to biopsy and pathologic examination

CPT 78012: Thyroid Radioiodine Uptake Study

CPT-78013-THYROID-RADIOIODINE-IMAGING-UPTAKE

CPT 78013: Thyroid Radioiodine Uptake and Imaging

CPT-78014-THYROID-RADIOIODINE-UPTAKE-IMAGING

CPT 78014: Thyroid Radioiodine Uptake Imaging

CPT-78015-THYROID-SCAN-NUCLEAR-MEDICINE

CPT 78015: Thyroid Scan, Nuclear Medicine Diagnostic Imaging

CPT-78016-THYROID-SCAN-NUCLEAR-MEDICINE-IMAGING

CPT 78016: Thyroid Scan, Nuclear Medicine Imaging

CPT-78018-THYROID-SCAN-NUCLEAR-MEDICINE-IMAGING

CPT 78018: Thyroid Scan, Nuclear Medicine Imaging

CPT-78070-PARATHYROID-DUAL-TRACER-IMAGING-SUBTRACTION-STUDY

CPT 78070: Parathyroid Dual-Tracer Imaging with Subtraction

CPT-78071-SPECT-PARATHYROID-IMAGING-DUAL-TRACER

CPT 78071: SPECT Parathyroid Imaging with Dual Tracers

CPT-78072-PARATHYROID-NUCLEAR-MEDICINE-SPECT-CT-LOCALIZATION

CPT 78072: Parathyroid Nuclear Medicine Imaging with SPECT/CT Localization

CPT-78075-FUNCTIONAL-ADRENAL-NUCLEAR-IMAGING

CPT 78075: Functional Adrenal Nuclear Imaging

Showing 1–10 of 11

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician interpretation/report for the thyroid scan separate from technical services
`TC`	Technical component	When billing only the imaging/technical component (camera, technologist, radiopharmaceutical)
`50`	Bilateral procedure	Rarely applicable; use when a procedure has distinct bilateral reporting requirements (generally not used for thyroid scan imaging)
`52`	Reduced services	When the study is partially completed or limited compared with standard protocol
`53`	Discontinued procedure	When the scan is started but halted for patient safety reasons
`59`	Distinct procedural service	When a separate, unrelated procedure is performed on the same day requiring separate reporting
`76`	Repeat procedure by same physician	Use when the same physician repeats the scan within the postoperative or relevant timeframe (not in raw list; omit if strict compliance required)
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use only if a related interventional procedure occurs (rare for imaging)
`22`	Increased procedural services	When the interpretation requires significantly greater effort or complexity than typical
`27`	Multiple outpatient hospital settings	Use when services are provided across multiple outpatient settings on the same date
`51`	Multiple procedures	When multiple radiology/nuclear medicine procedures are performed and payers require modifier for secondary procedures
`52`	Reduced services	When the full imaging protocol cannot be completed (duplicate entry — see above)
`QX`	Modifier indicating that the assistant at surgery is a qualified resident	Generally not applicable to imaging services but listed in raw modifiers

Taxonomy Code	Specialty	Notes
2085P0202X	Nuclear Medicine Physician	Interprets and reports radionuclide thyroid studies
207R00000X	Radiologist	Performs and interprets nuclear medicine imaging in many institutions
207L00000X	Diagnostic Radiology	Radiologists with diagnostic focus who may interpret thyroid scans
207K00000X	Endocrinology (consulting)	Refers patients and uses results for clinical management
2084P0800X	General Surgery (head & neck)	Uses scan results for surgical planning or surveillance

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E06.3`	Autoimmune thyroiditis	May present with abnormal uptake patterns prompting thyroid scan
`E03.9`	Hypothyroidism, unspecified	Scans may be used to evaluate residual tissue or ectopic uptake in complex cases
`E04.1`	Nontoxic single thyroid nodule	Localizes functioning versus nonfunctioning nodules
`C73`	Malignant neoplasm of thyroid gland	Post-thyroidectomy surveillance often includes whole-body or neck scans to detect residual or metastatic disease
`E05.90`	Thyrotoxicosis, unspecified without thyrotoxic crisis or storm	Thyroid scan helps differentiate causes of hyperthyroidism (e.g., Graves vs toxic nodule)

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`78020`	Thyroid uptake and imaging (static or dynamic), planar or SPECT	Primary CPT for radionuclide thyroid imaging to assess thyroid function and nodules
`78100`	Thyroid uptake (single quantitative determination)	Often performed in conjunction to quantify radionuclide uptake prior to or alongside imaging
`78800`	SPECT study without qualifying CT	May be performed if tomographic nuclear imaging of the neck is required for improved localization
`79005`	Radiopharmaceutical therapy or complex therapeutic nuclear medicine administration — (note: specific codes vary)	Related when a diagnostic scan leads to therapeutic radioactive iodine planning (use institution-specific therapy codes)
`88305`	Surgical pathology, gross and microscopic examination	May be related when focal uptake leads to biopsy and pathologic examination

CPT 78012: Thyroid Radioiodine Uptake Study

CPT-78013-THYROID-RADIOIODINE-IMAGING-UPTAKE

CPT 78013: Thyroid Radioiodine Uptake and Imaging

CPT-78014-THYROID-RADIOIODINE-UPTAKE-IMAGING

CPT 78014: Thyroid Radioiodine Uptake Imaging

CPT-78015-THYROID-SCAN-NUCLEAR-MEDICINE

CPT 78015: Thyroid Scan, Nuclear Medicine Diagnostic Imaging

CPT-78016-THYROID-SCAN-NUCLEAR-MEDICINE-IMAGING

CPT 78016: Thyroid Scan, Nuclear Medicine Imaging

CPT-78018-THYROID-SCAN-NUCLEAR-MEDICINE-IMAGING

CPT 78018: Thyroid Scan, Nuclear Medicine Imaging

CPT-78070-PARATHYROID-DUAL-TRACER-IMAGING-SUBTRACTION-STUDY

CPT 78070: Parathyroid Dual-Tracer Imaging with Subtraction

CPT-78071-SPECT-PARATHYROID-IMAGING-DUAL-TRACER

CPT 78071: SPECT Parathyroid Imaging with Dual Tracers

CPT-78072-PARATHYROID-NUCLEAR-MEDICINE-SPECT-CT-LOCALIZATION

CPT 78072: Parathyroid Nuclear Medicine Imaging with SPECT/CT Localization

CPT-78075-FUNCTIONAL-ADRENAL-NUCLEAR-IMAGING

CPT 78075: Functional Adrenal Nuclear Imaging

Showing 1–10 of 11

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 78020: Thyroid Scan, Nuclear Medicine

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Billing Code Overview

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OpenPayer

CPT 78020: Thyroid Scan, Nuclear Medicine

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References