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CPT 78725: Kidney Scan, Nuclear Medicine Renal Imaging
CPT code 78725 denotes a nuclear medicine kidney scan used to assess renal anatomy, perfusion, and drainage. The test can be performed as a cortical scan to evaluate renal shape and cortical defects, or as a functional scan to quantify tracer transit time and urinary drainage. This service is clinically important for diagnosing obstructive uropathy, renal cortical scarring, differential renal function, and post-transplant surveillance, making it a commonly referenced diagnostic study in nephrology and urology care pathways.
Key payers typically covering this service in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find information on clinical context, typical sites of service, common use cases, and payer coverage considerations relevant to these major payers. The publication also summarizes benchmarks, coding guidance, and recent policy updates affecting nuclear renal imaging reimbursement and documentation expectations.
This overview is intended for health plans, providers, and billing professionals seeking a concise reference to CPT code 78725, its clinical applications, and implications for billing and authorization across major national payers.
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Billing Code Overview
CPT code 78725 describes a kidney scan, a nuclear medicine study used to evaluate renal structure, function, and renal blood flow. The procedure includes two primary approaches: a cortical scan, which delineates the shape and cortical anatomy of the kidneys, and a functional scan, which measures tracer transit time through the kidneys, collection in the urine, and drainage into the bladder.
Service type: Nuclear medicine renal imaging
Typical site of service: Hospital outpatient imaging centers, freestanding nuclear medicine facilities, and outpatient radiology departments.