Ask Dr. Z

Patient received a treatment with mCi iodine-131 orally. One week later whole body with SPECT/CT imaging is performed. Are we allowed to code for 79005 separately, or is it integral to nuclear medicine imaging procedures subsequently performed a week later? Are codes 78018 and 78830 correct for the NM imaging?

"EXAMINATION: NM THYROID ABLATION TREATMENT

ASSOCIATED DIAGNOSIS: Papillary thyroid carcinoma

TECHNIQUE: The patient was treated with 102.5 mCi I-131 sodium iodide orally without immediate complication. 1 week later, delayed anterior and posterior whole body imaging from the vertex of the skull to the upper thigh was performed. Additional spot views of the neck with and without markers were also obtained.

FINDINGS: Planar whole body scan demonstrates an area of focal asymmetric iodine uptake in the right central neck compartment, which on SPECT/CT imaging corresponds to a small iodine-avid soft-tissue nodule in the right tracheoesophageal groove at the level of the thyroid bed consistent with postsurgical thyroid tissue remnant...."