Find policies, billing codes, payers, states, and providers
CPT 78803: Single-Area SPECT for Tumor or Inflammatory Localization
CPT code 78803 denotes a single-day, single-area SPECT nuclear imaging study used to localize tumors, detect inflammatory processes, or assess radioactive tracer distribution; vascular flow and blood pool imaging are included when performed. This code matters nationally because SPECT remains a common modality for functional localization in oncology, infection/inflammation workups, and other diagnostic scenarios where tomographic radionuclide imaging informs patient management and care pathways.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national overview of clinical context and coding definition, payer coverage considerations, common billing modifiers (listed separately), and how 78803 relates to single-area SPECT workflows across typical service sites.
Readers will learn the clinical role and operational setting for CPT code 78803, typical sites of service, and the scope of the procedure as a single-day, single-area acquisition. The report summarizes payer coverage landscape and identifies areas where coding clarification or payer-specific guidance may affect billing and claims adjudication. Data not available in the input is noted where applicable.
Customize your policy alerts
Sign up for cpt 78803 policy alerts
Get alerted when payer policies referencing 78803 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 78803 describes a single-day single-area SPECT (single photon emission computed tomography) imaging study used to localize a tumor, identify an inflammatory process, or evaluate the distribution of a radioactive tracer. The procedure includes vascular flow and blood pool imaging when those components are performed.
Service type: Nuclear medicine imaging (SPECT), single-day single-area acquisition.
Typical site of service: Hospital outpatient radiology/nuclear medicine department, freestanding imaging center, or specialized nuclear medicine clinic where SPECT studies of a single area (for example, the head, neck, chest, or pelvis) are performed.