Pulmonology Coding Alert

Question: Our physician performed pulmonary ventilation/perfusion imaging with aerosol ventilation and lung perfusion. Two projections were done. Which code should I use and how many times? 

Georgia Subscriber  
Answer: Use 78588 (pulmonary perfusion imaging, particulate, with ventilation imaging, aerosol, one or multiple projections). This code combines the procedures described in 78580 (pulmonary perfusion imaging, particulate), 78586 (pulmonary ventilation imaging, aerosol; single projection) and 78587 ( multiple projections [e.g., anterior, posterior, lateral views]). To report 78588, the physician must perform the imaging twice once after the patient inhaled a radioactive aerosol and another after the patient was injected with a radioactive particulate. The descriptor for 78588 says "one or multiple projections," so it should be reported only once no matter how many projections are performed.