Summary & Overview
CPT 78202: Liver and Spleen Scan, Nuclear Medicine
CPT code 78202 represents a liver and spleen scan, a nuclear medicine diagnostic imaging procedure used to evaluate the structure and function of the liver and spleen. Nationally, this code matters for clinical pathways that require targeted imaging to detect focal lesions, assess splenic involvement, or quantify hepatic function in a range of conditions including infection, trauma, and suspected neoplasm.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes how these payers typically classify and reimburse nuclear medicine imaging for hepatic and splenic evaluation and highlights common billing considerations.
Readers will learn the clinical context for ordering a liver and spleen scan, typical sites of service, and the scope of services captured by CPT code 78202. The report provides benchmark-oriented content: expected service line placement, payer coverage patterns, and the clinical indications that commonly support billing. Where specific input data is lacking, the report notes that the information is not available in the input. This resource is intended as a clear, national-level reference for clinical managers, coding staff, and policy analysts seeking concise guidance on the role and classification of CPT code 78202 within nuclear medicine imaging.
Billing Code Overview
CPT code 78202 denotes a liver and spleen scan, a specialized radiologic procedure used to evaluate the anatomy and function of the liver and spleen. The scan is performed to identify focal lesions, assess organ size and perfusion, and evaluate functional disorders affecting these organs.
Service Type: Nuclear medicine diagnostic imaging of the liver and spleen
Typical Site of Service: Hospital outpatient imaging centers, freestanding radiology or nuclear medicine clinics, and ambulatory surgical centers equipped for nuclear medicine procedures.
Clinical & Coding Specifications
Clinical Context
A 56-year-old patient with a history of chronic hepatitis C and recent unexplained left upper quadrant pain is referred for a diagnostic liver and spleen scan to assess organ perfusion, detect focal lesions, and evaluate splenic size and function. The outpatient workup is ordered by a hepatology clinic after abnormal liver function tests and an ultrasound that suggested possible splenomegaly and heterogeneous hepatic uptake. The nuclear medicine department schedules the study as an outpatient visit; the patient arrives fasting per department protocol, an intravenous line is established, and a radiopharmaceutical (commonly Tc-99m labeled colloid or sulfur colloid depending on protocol) is administered. Dynamic and delayed imaging sequences are obtained of the liver and spleen. The interpreting nuclear medicine physician reviews images for focal defects, uptake patterns, and relative organ function, documents findings in the radiology report, and provides results to the referring hepatologist for further management planning. Typical sites of service are hospital outpatient imaging centers, freestanding imaging centers, or hospital radiology/nuclear medicine departments. The service type is a diagnostic nuclear medicine scan of the liver and spleen specific to functional and structural assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation/report is billed separate from the technical component. |