Summary & Overview
CPT 78597: Pulmonary Perfusion Quantitative Nuclear Scan
CPT code 78597 identifies a pulmonary perfusion nuclear medicine procedure that performs quantitative analysis of differential pulmonary artery blood flow. This diagnostic test evaluates regional lung perfusion and can be used in clinical pathways for pulmonary embolism assessment, preoperative evaluation, and other causes of asymmetric pulmonary blood flow. The code is nationally relevant because it supports decisions about imaging strategies, anticoagulation, and surgical planning in cardiopulmonary care.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and service setting for the code, guidance on typical sites of service, and notes about common billing considerations. Where available, the publication presents benchmarks and coverage patterns, as well as references to policy language and coding guidance that affect claim adjudication.
This summary helps clinicians, coding professionals, and billing managers understand what CPT code 78597 represents, why it matters in patient care workflows, and the practical contexts in which the service is delivered. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 78597 describes a pulmonary perfusion nuclear scan performed to evaluate blood flow within the lungs. The procedure focuses on quantitative analysis of differential pulmonary artery blood flow and may include imaging but does not require it.
Service type: Diagnostic nuclear medicine study — pulmonary perfusion quantification
Typical site of service: Hospital outpatient department, outpatient imaging center, or nuclear medicine facility
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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.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the physician interpretation of the perfusion study separate from technical services |