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    v1.0.30
    OpenPayerBilling CodesDiagnostic Nuclear Medicine Procedures on the Musculoskeletal SystemCPT cpt-78399-musculoskeletal-nuclear-medicine-unlisted-procedure
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    CPT 78399: Musculoskeletal Diagnostic Nuclear Medicine Procedure (Unlisted)

    CPT code 78399 describes an unlisted musculoskeletal diagnostic nuclear medicine procedure used when no specific CPT code exists for the performed study; the service is a musculoskeletal nuclear medicine diagnostic exam typically performed in a nuclear medicine department or hospital outpatient imaging center to evaluate bone or soft-tissue pathology using radiotracers.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM), Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®), Lumbar Microdiscectomy.

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with chronic, progressive hip and pelvic pain after prior joint surgery presents for evaluation of suspected occult prosthetic loosening and regional bone metabolism abnormalities. The referring orthopedic surgeon orders a specialized musculoskeletal nuclear medicine study because standard radiographs and CT were inconclusive. The nuclear medicine department schedules the patient for a diagnostic bone scan variant that is not described by a specific CPT code and will be reported using 78399.

    The clinical workflow includes patient check-in, verification of indications and allergies, IV access and radiotracer administration, a variable imaging protocol tailored to the suspected anatomic region (delayed static views, spot views, or SPECT/CT acquisition of the pelvis and hips), image processing and interpretation by a board-certified nuclear medicine physician, and generation of a final report documenting findings relevant to prosthetic integrity, focal osteoblastic activity, infection vs. loosening, and recommendations for correlation with clinical and surgical findings. Typical site of service is an outpatient hospital-based imaging center or freestanding nuclear medicine clinic; inpatient performance is possible when ordered during hospitalization.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78399Unlisted musculoskeletal diagnostic nuclear medicine procedureUse for reporting the specific musculoskeletal nuclear medicine study that lacks a specific CPT code; primary code for this service.
    78800Unlisted nuclear medicine procedureAlternative unlisted code sometimes used for non-specific nuclear medicine studies when payer requires.
    78803Radiopharmaceutical localization of bone, whole body, single or multi-spot viewsOften performed as a standard three-phase bone scan when more specific musculoskeletal imaging is required before or after an unlisted study.
    78831Bone imaging, limited area, tomographic (SPECT)Performed when SPECT is required to localize focal lesions identified on planar or unlisted studies.
    0265TSPECT/CT image-guided localization, musculoskeletal (example)Used when hybrid SPECT/CT is performed to provide anatomic correlation; may accompany or replace an unlisted study if available.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207R00000X
    363A00000X
    2084P0800X
    102X00000X
    261QM1100X
    111NS0005X
    193400000X
    213E00000X

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Lumbar Microdiscectomyuniverahealthcare2026-10-15
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Decompressionuniverahealthcare2026-10-15
    Responsive Neurostimulation for Focal EpilepsyPremera Bluecross2026-10-14
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    High-Intensity Focused UltrasoundMass General Brigham Health Plan2026-10-01
    Vagal Nerve StimulationAmbetter Nevada2026-10-01

    Related Codes

    CPT-78300-BONE-SCAN-LIMITED-AREA-SCINTIGRAPHY

    CPT 78300: Bone Scan (Limited Area Scintigraphy)

    CPT-78305-BONE-SCAN-SCINTIGRAPHY-MULTI-REGION

    CPT 78305: Bone Scan (Skeletal Scintigraphy)

    CPT-78306-FULL-BODY-BONE-SCAN-SCINTIGRAPHY

    CPT 78306: Full‑Body Bone Scan (Scintigraphy)

    CPT-78315-THREE-PHASE-BONE-SCAN-SCINTIGRAPHY

    CPT 78315: Three-Phase Bone Scan (Scintigraphy)

    CPT-78350-BONE-MINERAL-DENSITY-SINGLE-PHOTON-ABSORPTIOMETRY

    CPT 78350: Single-Energy Photon Bone Mineral Density Measurement

    CPT-78351-BONE-MINERAL-DENSITY-DUAL-ENERGY-PHOTON-ABSORPTIOMETRY

    CPT 78351: Dual-Energy Photon Bone Mineral Density Measurement

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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