Summary & Overview
CPT 78104: Whole-Body Bone Scan, Skeletal Scintigraphy
CPT code 78104 is a national billing code for a whole-body skeletal scintigraphy performed after intravenous injection of a radiopharmaceutical. The study captures serial images of the entire skeleton to assess tracer uptake, commonly used to detect metastatic disease, occult fractures, infection, and other metabolic bone disorders. As a standardized diagnostic nuclear medicine procedure, CPT code 78104 supports clinical decision-making across inpatient and outpatient imaging settings and influences utilization and coverage policies for advanced imaging.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what CPT code 78104 represents, typical sites of service, and the clinical contexts in which whole-body bone scans are applied. The publication also summarizes common billing considerations, reimbursement benchmarks where available, and policy developments that affect nationwide coverage for nuclear medicine skeletal imaging.
This resource is designed for coding professionals, radiology administrators, and policy analysts seeking a clear, national-level reference on CPT code 78104, including operational implications for imaging departments and payers.
Billing Code Overview
CPT code 78104 describes a whole-body skeletal imaging study performed after intravenous administration of a radiopharmaceutical (radiotracer). This noninvasive nuclear medicine scan images the entire skeleton in intervals to capture tracer distribution and uptake patterns.
Service type: Diagnostic nuclear medicine study (whole-body bone scan)
Typical site of service: Hospital outpatient department, imaging center, or freestanding nuclear medicine facility
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred by an oncologist for evaluation of suspected osseous metastatic disease based on new bone pain and an abnormal tumor marker or prior imaging. The patient arrives to a nuclear medicine department or an outpatient radiology clinic. Intravenous access is obtained, a technologist administers a radiopharmaceutical (radiotracer), and the patient rests for the appropriate uptake period. The provider performs a whole-body scan in multiple intervals using a gamma camera or SPECT system to image tracer distribution through the entire skeleton. Images are reviewed by a nuclear medicine physician who documents findings, compares with prior studies when available, and issues a coded report for billing. Typical sites of service include an outpatient hospital imaging center, freestanding nuclear medicine facility, or hospital radiology department.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the physician interpretation separate from technical services |
TC | Technical component | When reporting only equipment, radiopharmaceutical, and technologist services |