Radiology Coding Alert

Question: We had a patient visit our radiology clinic for bone and joint imaging of both wrists. The report also indicates the physician captured delayed status images, blood pool, and blood flow.

Should I report a multiple area bone/joint imaging code?

North Dakota Subscriber

Answer: No, you should assign 78315 (Bone and/or joint imaging; 3 phase study) instead of 78305 (… multiple areas). The three-phase study imaging scan includes the factors you mentioned in your question of the delayed status images, vascular flow, and blood pool. These additional study portions help the provider make an informed medical decision, as the extra details provide information on bone activity and possible abnormalities.

While 78305 lists “multiple areas” in the code descriptor, the code only covers imaging of more than one body area — it does not include the additional work performed by the physician during a three-phase study.

On the other hand, 78300 (… limited area) is designated for bone and joint imaging scans performed on a limited area or a specific number of bones and joints on the patient’s body. Lastly, you’ll assign 78306 (… whole body) if the provider captures images of all of the patient’s bones and joints in their body.

Mike Shaughnessy, BA, CPC, Development Editor, AAPC