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    OpenPayerBilling CodesDiagnostic Nuclear Medicine Procedures on the Respiratory SystemCPT cpt-78597-pulmonary-perfusion-quantitative-nuclear-scan
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    CPT 78597: Pulmonary Perfusion Quantitative Blood Flow

    Medicare pays $125 on average nationally for this procedure.

    CPT code 78597 describes a pulmonary perfusion nuclear medicine procedure performed to quantify differential pulmonary artery blood flow, typically categorized as a diagnostic nuclear perfusion study; the service type is a diagnostic pulmonary perfusion study and the typical site of service is a hospital outpatient imaging department or outpatient nuclear medicine center.

    For related coverage guidance, see recent payer policy updates: Vafseo (vadadustat) for anemia in CKD on dialysis, Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family Plans, Kerendia (finerenone) — Coverage Criteria.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with progressive exertional dyspnea and a history of prior pulmonary embolism is referred for a quantitative pulmonary perfusion nuclear scan to evaluate differential pulmonary blood flow and to assess for chronic thromboembolic pulmonary hypertension (CTEPH) or residual perfusion defects. The procedure is scheduled through the hospital's nuclear medicine department. Pre-procedure workflow includes verification of indications, review of recent anticoagulation status, screening for pregnancy in women of childbearing potential, and informed consent. The nuclear medicine technologist establishes intravenous access, injects the radiopharmaceutical (commonly Tc-99m macroaggregated albumin), and the imaging is performed by the technologist under the supervision of the interpreting nuclear medicine physician. Quantitative counts are obtained for each lung and, if imaging is performed, planar or SPECT images document regional perfusion. The interpreting physician reviews quantitative perfusion values, compares with any prior studies, and issues a report detailing percent perfusion by lung or lobe and any focal defects. Typical site of service is the hospital outpatient radiology/nuclear medicine department or an independent diagnostic imaging center. Service type is a nuclear medicine perfusion study (diagnostic nuclear imaging) focused on pulmonary perfusion with quantitative differential blood flow analysis.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78597Pulmonary perfusion, quantitative; with or without imaging — nuclear medicine perfusion study to evaluate differential pulmonary artery blood flow.Primary procedure: quantitative analysis of differential pulmonary blood flow; imaging optional.
    78800Radiopharmaceutical therapy and imaging (single-photon) — planar, SPECT or other nuclear medicine imaging (single study).May be performed concurrently when additional thoracic nuclear imaging is required or when imaging component is billed separately by the technical component provider.
    71046Radiologic examination, chest, 2 views, frontal and lateral.Ordered adjunctively when correlation with chest radiograph is needed for interpretation of perfusion defects.
    93571Right heart catheterization with measurement of pulmonary artery pressures (including oxygen saturations) (Note: invasive procedure).Performed before or after perfusion imaging when invasive hemodynamic assessment is required for suspected pulmonary hypertension or CTEPH.
    94799Unlisted pulmonary service or procedure.Used when a closely matching code is not available for a nonstandard or experimental perfusion technique.

    Related Modifiers

    8 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…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207K00000X
    207P00000X
    207L00000X
    207RR0500X
    103TM1700X
    122400000X
    225CX0006X
    175L00000X

    Related Payer Policy Updates

    Specialty: Nephrology1 / 3

    10 rows

    PolicyPayerEffective Date
    Vafseo (vadadustat) for anemia in CKD on dialysisCigna2026-08-15
    Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family PlansCigna2026-08-15
    Kerendia (finerenone) — Coverage CriteriaBlue Cross Blue Shield - Iowa2026-08-05
    Voyxact (sibeprenlimab-szsl) — Prior authorization / medical necessity for primary IgA nephropathyColorado Rocky Mountain Health Plans2026-08-01
    Oxlumo (lumasiran) and Rivfloza (nedosiran) — Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Korsuva (difelikefalin) — Medical Benefit Drug Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Complement Inhibitors - EmpaveliCigna2026-08-01
    Tolvaptan (Jynarque)Cigna2026-08-01
    Nephrology - Filspari (sparsentan) coverageCigna2026-08-01
    Rivfloza (nedosiran) prior authorization for PH1UnitedHealthcare2026-08-01

    Related Codes

    CPT-78579-PULMONARY-VENTILATION-IMAGING-NUCLEAR-SCAN

    CPT 78579: Pulmonary Ventilation Imaging

    CPT-78580-PULMONARY-PERFUSION-NUCLEAR-IMAGING

    CPT 78580: Lung Perfusion Nuclear Imaging for Pulmonary Embolism

    CPT-78582-PULMONARY-VENTILATION-AND-PERFUSION-NUCLEAR-SCAN

    CPT 78582: Pulmonary Ventilation and Perfusion Nuclear Scan

    CPT-78598-PULMONARY-VENTILATION-PERFUSION-QUANTITATIVE-SCAN

    CPT 78598: Quantitative Pulmonary Ventilation and Perfusion Scan

    CPT-78599-UNLISTED-RESPIRATORY-NUCLEAR-MEDICINE-PROCEDURE

    CPT 78599: Respiratory Diagnostic Nuclear Medicine, Unlisted Procedure

    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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