CPT code 78216 designates a liver and spleen scan, a diagnostic imaging procedure used to evaluate organ structure and function. Nationally, this code is relevant for practices that provide nuclear medicine or specialized radiologic studies to detect focal lesions, assess splenic pathology, and evaluate hepatic uptake patterns. Use of this code affects imaging workflow, claim adjudication, and resource allocation in outpatient and inpatient settings.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, payer coverage considerations, and common billing components tied to the service line. The publication summarizes benchmarks for utilization where available, notes common modifier usage, and highlights coding and documentation elements that routinely influence claim processing.

This resource is intended to give clinicians, coding professionals, and revenue cycle staff a clear national-level briefing on the clinical purpose of the scan, typical places of service, and the payer landscape that commonly reimburses this diagnostic imaging study. Data not available in the input is explicitly noted where applicable.