Summary & Overview
CPT 78231: Salivary Gland Nuclear Imaging, Serial Post-Injection
CPT code 78231 denotes a nuclear medicine diagnostic imaging study of the salivary glands performed with serial imaging following intravenous injection of a radiopharmaceutical. This test assesses salivary gland function and structural abnormalities and is commonly used in the evaluation of xerostomia, salivary gland obstruction, inflammatory conditions, and suspected gland dysfunction. Nationally, the code matters because it captures utilization of a specialized diagnostic modality that informs management decisions in otolaryngology, oral surgery, and rheumatology.
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, typical sites of service, common claim modifiers, and the expected service line classification. The publication summarizes benchmark considerations and payer coverage practices where available, highlights relevant billing and coding implications for providers who perform or order salivary gland nuclear imaging, and identifies gaps in the available input data.
This national overview is intended for health plan analysts, coding professionals, and clinical leaders who need a clear synopsis of what CPT code 78231 represents, how it is used clinically, and which major public and commercial payers are relevant to coverage and claims processing.
Billing Code Overview
CPT code 78231 describes a diagnostic imaging procedure in which the provider acquires serial images of the salivary glands after intravenous administration of a radiopharmaceutical or tracer. This study evaluates salivary gland function and morphology using nuclear medicine imaging techniques.
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Service type: Nuclear medicine diagnostic imaging
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Typical site of service: Outpatient imaging center or hospital-based nuclear medicine department
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to nuclear medicine for evaluation of salivary gland function after symptoms such as chronic dry mouth (xerostomia), suspected obstructive sialolithiasis, recurrent swelling of the parotid or submandibular glands, or evaluation before/after radiation therapy to the head and neck. The ordering clinician (often an otolaryngologist, oral/maxillofacial surgeon, or radiation oncologist) documents symptoms, relevant history (e.g., Sjögren syndrome, prior surgery, suspected ductal obstruction), and a focused physical exam. The patient arrives to an outpatient nuclear medicine or radiology department; intravenous access is obtained and the radiopharmaceutical (commonly technetium-99m pertechnetate) is administered. Serial planar images or dynamic imaging of the salivary glands are obtained over a set time interval to assess uptake and excretion. The interpreting physician (nuclear medicine physician or radiologist) reviews dynamic time-activity curves and images, generates a report describing gland perfusion, uptake, and excretory function, and provides results to the referring provider for clinical management decisions such as sialagogues, ductal intervention, or further imaging.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician's professional component separate from the technical imaging services. |