Radiology Coding Alert

Question: How should I report a HIDA scan?

Massachusetts Subscriber

Answer: The appropriate CPT code is 78223 (Hepatobiliary ductal system imaging, including gallbladder, with or without pharmacologic intervention, with or without quantitative measurement of gallbladder function).

If you are reporting the scan agent also, base your HCPCS code choice on the documentation. Agents you may see include:

• Iminodiacetic Acid (IDA): A4641 -- Radiopharmaceutical, diagnostic, not otherwise classified
• Disofenin (Hepatolite, DISIDA): A9510 -- Technetium Tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries
• Mebrofenin (Choletec): A9537 -- Technetium Tc-99m mebrofenin diagnostic, per study dose, up to 15 millicuries.

Reimbursement for 78223 includes the injection procedure, so you should not report a separate intravenous injection code for the physician's work injecting the radiopharmaceutical.

HIDA: Physicians use a hepatobiliary iminodiacetic acid (HIDA) scan to examine the gallbladder and the ducts leading into and out of it. Physicians often perform these tests to determine whether patients have bile duct obstructions.

You may see the exam referred to as cholescintigraphy, hepatobiliary scintigraphy, hepatobiliary scan, or gallbladder scan.