CPT 78140 Liver-Spleen Scan Reimbursement

CPT code 78140 represents a diagnostic nuclear medicine procedure in which a patient’s own red blood cells are tagged with a radiopharmaceutical and used to image the liver and spleen. Nationally relevant for hospitals and imaging centers, this study aids in identifying ectopic splenic tissue, vascular lesions, and focal hepatic or splenic abnormalities that impact diagnosis and care planning. The code is used across hospital outpatient departments and dedicated nuclear medicine clinics where radiolabeled autologous erythrocyte imaging is available.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for the scan, typical sites of service, and standard billing considerations tied to CPT code 78140. The publication outlines national-level benchmarks and utilization patterns where available, summarizes payer coverage trends and prior authorization considerations, and highlights coding and documentation points important for accurate claims submission. Data not available in the input is noted where necessary. This summary is intended for billing managers, hospital administrators, and clinicians involved in diagnostic nuclear medicine coding and revenue cycle oversight.

Billing Code Overview

CPT code 78140 describes a nuclear medicine study of the liver and spleen performed after intravenous injection of the patient’s own red blood cells labeled with a radiopharmaceutical. The procedure evaluates splenic and hepatic function and distribution of labeled erythrocytes to detect ectopic splenic tissue, hemangiomas, infarcts, or focal lesions.

Service type: Diagnostic nuclear medicine procedure using autologous labeled red blood cells

Typical site of service: Hospital outpatient imaging department or outpatient nuclear medicine clinic

Clinical Context

A 58-year-old patient with chronic anemia and unexplained splenomegaly is referred for a radionuclide red blood cell (RBC) study of the liver and spleen to evaluate for occult splenic sequestration and to quantify splenic function. The nuclear medicine team schedules the patient for autologous RBC labeling with a radiopharmaceutical (typically technetium-99m) followed by planar and/or SPECT imaging of the hepatic-splenic region. The workflow includes pre-procedure verification, blood draw for in-vitro or in-vivo RBC tagging, radiotracer incubation, reinjection of the labeled RBCs, serial imaging at specified time points, image processing, and interpretation.

Indications include investigation of suspected splenic sequestration in hemolytic anemias, localization of accessory spleen tissue, evaluation of post-splenectomy residual splenic tissue, and differentiation of focal hepatic lesions from splenic tissue. Typical personnel include a nuclear medicine physician (interpretation), nuclear medicine technologist (labeling and imaging), and nursing staff (venipuncture and patient monitoring). The typical site of service is an outpatient imaging center or hospital nuclear medicine department, with the procedure billed using the radionuclide liver-spleen RBC study code 78140.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component

Taxonomy Code	Specialty	Notes
208K00000X	Nuclear Medicine Physician	Interprets and oversees radionuclide imaging and radiopharmaceutical use.
364S00000X	Radiology - Nuclear Medicine	Physicians with procedural expertise in diagnostic nuclear studies.
3336C0002X	Diagnostic Radiology	Radiologists who may interpret nuclear medicine studies in some settings.
3356C0002X	Nuclear Medicine Technologist	Performs radiolabeling and image acquisition under supervision.
207L00000X	Internal Medicine (Hematology focus)	Referring specialty for indications such as hemolytic anemia and splenomegaly.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D73.0`	Splenomegaly	Direct indication for liver-spleen RBC study to evaluate splenic size and function.
`D55.0`	Anemia due to glucose-6-phosphate dehydrogenase deficiency	Hemolytic anemias prompting evaluation for splenic sequestration.
`D59.1`	Secondary hemolytic anemia	Indication to assess splenic sequestration of RBCs.
`R16.1`	Hepatomegaly	Evaluation may include differentiation of hepatic vs splenic masses.
`R16.0`	Splenomegaly, unspecified	Common presenting diagnosis for this imaging study.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`78140`	Liver and spleen study using autologous tagged red blood cells	Primary procedure: radionuclide labeling of patient's RBCs and imaging of liver and spleen.
`78830`	Particle imaging (e.g., gastrointestinal bleeding)	May be used in evaluation of active GI bleeding with labeled RBCs; different study focus but similar radiopharmaceutical techniques.
`93010`	Rhythm monitoring during procedures (not nuclear)	Typically unrelated; included only when cardiac monitoring is performed for patient safety during the imaging session.
`A9526`	Technetium Tc-99m medronate diagnostic radiopharmaceutical (note: A-codes are HCPCS)	Radiopharmaceutical supply codes may be billed in conjunction with nuclear procedures depending on payer rules.
`78266`	Liver/spleen imaging other radionuclide studies	Alternative or adjunct radionuclide liver/spleen studies depending on protocol and imaging technique.

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Summary & Overview

CPT 78140: Liver and Spleen Scan with Radiolabeled Autologous Red Blood Cells