Summary & Overview
CPT 78709: Kidney Scan, Renal Structure and Function
CPT code 78709 denotes a nuclear medicine kidney scan used to evaluate renal anatomy, perfusion, and functional drainage. The study can be performed as a cortical scan to visualize renal morphology or as a functional scan to quantify radionuclide transit and drainage into the bladder. Nationally, this imaging modality supports diagnosis and management of obstructive uropathy, renovascular disease, renal perfusion abnormalities, and post-transplant surveillance.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and typical settings for the service, an outline of common modifiers associated with billing, and pointers to related billing and coding considerations. The publication provides practical benchmarking context and policy-relevant updates that affect coverage and claims adjudication for nuclear renal imaging.
This summary equips clinicians, coding professionals, and policy analysts with the essential clinical context and payer scope for CPT code 78709, along with guidance on where to look for further details on payer-specific coverage and reimbursement practices.
Billing Code Overview
CPT code 78709 describes a kidney scan, a nuclear medicine diagnostic imaging study used to evaluate renal structure, function, and perfusion. The procedure includes two primary approaches: a cortical scan to assess the shape and cortical anatomy of the kidneys, and a functional scan to measure transit time of the radionuclide through the kidneys, its collection in the urinary system, and drainage into the bladder.
Service Type: Nuclear medicine renal imaging
Typical Site of Service: Hospital outpatient imaging department or outpatient radiology/nuclear medicine center, and in some cases ambulatory surgical centers equipped for nuclear medicine studies.
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old adult referred by a nephrologist for a nuclear medicine renal scan (78709) to evaluate renal perfusion and function after recurrent urinary tract obstruction and episodes of flank pain. The patient presents to an outpatient nuclear medicine department after review of prior ultrasound showing unilateral hydronephrosis and serum creatinine trending upward. The clinical workflow includes pre-procedure verification (consent, allergy and pregnancy screening), intravenous placement for radiotracer administration, baseline hydration instructions, performance of a cortical and/or functional dynamic renal scintigraphy protocol with gamma camera imaging, image processing and quantitative time-activity curve generation, and interpretation by a radiologist or nuclear medicine physician. Images and a signed report are transmitted to the referring nephrologist and primary care provider. Typical sites of service are the hospital outpatient radiology/nuclear medicine department or an independent imaging center. The encounter may involve the professional component (interpretation) and technical component (radiopharmaceutical, imaging equipment, technologist services).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/report for the renal scan separate from the technical component. |