Nuclear medicine includes a broad range of diagnostic and therapeutic procedures. CPT codes for nuclear medicine diagnostic procedures cover diagnostic imaging across multiple organ systems, making it challenging to assign the most appropriate codes.
Diagnostic nuclear medicine procedures span multiple organ systems, and a thorough understanding of coding guidelines and National Correct Coding Initiative (NCCI) edits for PET and SPECT studies is necessary to support compliant and accurate claim submission. AI medical coding technologies are emerging as valuable tools for automating code suggestions and improving coding accuracy, though human oversight is still essential.
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This post outlines the CPT codes used to bill diagnostic nuclear medicine procedures, discusses key nuclear medicine billing and coding guidelines, and reviews the CPT code changes impacting nuclear medicine services in 2026.
What is the CPT Code Range for Nuclear Medicine Diagnostic Procedures?
The CPT code range for nuclear medicine diagnostic procedures is 78012-78999.
78012-78099 – Diagnostic Nuclear Medicine Procedures on the Endocrine System
- 78012 Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)
- 78020 Thyroid Carcinoma Metastases Uptake
- 78070 Parathyroid planar imaging (including subtraction, when performed)
- 78075 Adrenal Nuclear Imaging
78102-78199 – Diagnostic Nuclear Medicine Procedures on the Hematopoietic, Reticuloendothelial and Lymphatic System
- 78102 Bone Marrow Imaging, Limited
- 78140 Labeled Red Cell Sequestration
- 78185 Spleen Imaging With & Without Vascular Flow
- 78195 Lymph System Imaging
78201-78299 – Diagnostic Nuclear Medicine Procedures on the Gastrointestinal System
- 78202 Liver Imaging With Flow
- 78215 Liver & Spleen Imaging
- 78261 Gastric Mucosa Imaging
- 78290 Meckel’s Diverticulum Imaging
78300-78399 – Diagnostic Nuclear Medicine Procedures on the Musculoskeletal System
- 78300 Bone or Joint Imaging Limited
- 78305 Bone or Joint Imaging Multiple
- 78315 Bone Scan 3 Phase Study
- 78320 Bone Joint Imaging Tomo Test SPECT
78414-78499 – Diagnostic Nuclear Medicine Procedures on the Cardiovascular System
- 78414 Non-Imaging Heart Function
- 78428 Cardiac Shunt Imaging
- 78456 Acute Venous Thrombosis Imaging
- 78458 Venous Thrombosis Images, Bilateral
78579-78599 – Diagnostic Nuclear Medicine Procedures on the Respiratory System
- 78579 Pulmonary ventilation imaging (e.g., aerosol or gas)
- 78580 Pulmonary perfusion imaging (e.g., particulate)
- 78582 Pulmonary ventilation (e.g., aerosol or gas) and perfusion imaging
- 78597 Quantitative differential pulmonary perfusion, including imaging when performed
78600-78699 – Diagnostic Nuclear Medicine Procedures on the Nervous System
- 78601 Brain Limited Imaging and Flow
- 78630 Cisternogram (Cerebrospinal Fluid Flow)
- 78647 Cerebrospinal Fluid Scan (Tomographic) SPECT
- 78699 Unlisted Nuclear Medicine Procedures on the Nervous System
78700-78799 – Diagnostic Nuclear Medicine Procedures on the Genitourinary System
- 78708 Kidney Imaging Single Study With Pharmacological Intervention
- 78725 Kidney Function Study – Non-Imaging Radioisotopic
- 78730 Urinary Bladder Residual Study
- 78740 Ureteral Reflux Study
78800-78999 – Other Diagnostic Nuclear Medicine Procedures
- 78801 Radiopharmaceutical Localization of Tumor, Multiple Areas
- 78803 Radiopharmaceutical Localization of Tumor Tomographic (SPECT)
- 78806 Radiopharmaceutical Localization of Abscess, Whole Body
- 78999 Unlisted procedure, diagnostic nuclear medicine-radiation therapy treatment planning
Nuclear Medicine Coding Guidelines for Radiology Practices
Radiology practices must follow strict guidelines to ensure correct billing and avoid claim denials.
Key coding guidelines:
- Split the Components
Most nuclear medicine codes can be split into two parts using modifiers:
- Modifier 26 (Professional Component): Used when the radiologist only reads and interprets the scan.
- Modifier TC (Technical Component): Used when the clinic owns the equipment and employs the staff who did the scan.
- No Modifier: Bill the code by itself if the provider did both parts in their own facility.
- Bill Radiopharmaceuticals Separately
Since the radioactive tracer itself is not included in the CPT imaging code, it must be reported separately using HCPCS Level II codes.
- Check for Bundled Services
- Separate Procedures: Some codes are labeled as “separate procedures” in the CPT manual. Do not bill them if they are done as part of a larger, more comprehensive scan.
- Modifier 59: If a bundled service was done on a completely separate body part or during a different session, append modifier 59 to show it was independently.
The CPT coding combinations used must be compliant with the latest CMS rules, avoiding unbundling errors and ensuring proper reimbursement.
Example:
A patient undergoes a SPECT scan (CPT 78803) with radiopharmaceutical localization, and the physician also documents a planar whole‑body scan (CPT 78802).
NCCI Edit: CPT 78803 (SPECT) bundles the diagnostic planar imaging if performed in the same session.
Correct Coding: Report 78803 only — do not bill 78802 separately, because NCCI edits prohibit unbundling.
Append Modifier 59 only if the planar scan was performed as a distinct, medically necessary service (e.g., different anatomical area, separate session).
- Document Medical Necessity
- If a final diagnosis is not known at the time of coding, you must use the patient’s specific signs or symptoms (like chest or bone pain) to justify the test.
- Routine screenings or tests without symptoms require specific ICD-10 “Z codes”.
For many diagnostic nuclear medicine procedures, most insurers require prior authorization. Failure to obtain authorization or submit the necessary clinical documentation can result in claim denials and delayed reimbursement.
Key 2026 CPT Changes Affecting Nuclear Medicine
For CY 2026, Nuclear Medicine and Radiology coding updates include payment threshold modifications for diagnostic radiopharmaceuticals and revised Ambulatory Payment Classification (APC) assignments for specific procedures like SPECT imaging.
Reassignment of CPT Codes
The CY 2026 OPPS rule reduced reimbursement for CPT codes 78802, 78803, 78804, and 78432 due to radiopharmaceutical unpackaging and cost-reporting changes, resulting in APC reassignments and lower payment rates. CPT 78803 (SPECT single area) and CPT 93017 (stress test technical component saw the most significant cuts.
Diagnostic radiology procedure CPT codes moved to a lower category in 2026:
- 78803 – Tumor/inflammation localization, SPECT single area, single day
- 78802 – Tumor/inflammation localization, planar whole body, single day
- 78804 – Tumor/inflammation localization, planar whole body, 2+ days
- 93017 – Cardiovascular stress test, technical component only
- 78432 – PET myocardial perfusion & metabolism, dual tracer (remains contractor-priced with variable payment)
- 78800 – Tumor/inflammation localization, planar single area, single day (Payment is lower compared to more complex codes (e.g., 78802 whole body, 78803 SPECT, 78804 multi-day).
New Codes
CMS also launched two new codes relevant to nuclear medicine:
- C9176 (Tc-99m from domestically produced non-HEU Mo-99, [minimum 50 percent], full cost recovery add-on, per study dose), effective January 1, 2026.
- A9616 Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie, a new HCPCS code, effective October 1, 2025, for radiopharmaceutical supply.
Related Radiology and Radiation Oncology Changes
Changes were also made to intersecting radiology and radiation oncology services:
- 77402, 77407, and 77412 radiation treatment delivery codes were consolidated into three complexity-based tiers (Levels 1, 2, and 3).
- 77385 and 77386 Intensity Modulated Radiation Therapy (IMRT) delivery codes were deleted because the work is now captured within the revised delivery tiers.
- 77387 Image Guidance – The technical component of image guidance is now bundled into the revised delivery codes, meaning 77014 (CT guidance for placement of radiation therapy) has been deleted. The professional component is now billed using CPT 77387.
Nuclear Medicine Billing and Coding: The Value of Expert Assistance
Accurate claims submission requires a thorough understanding of the CPT codes for nuclear medicine diagnostic procedures, coding guidelines, NCCI edits, and payer-specific requirements. With annual coding updates and evolving reimbursement policies, maintaining compliance and minimizing denials can be challenging.
Partnering with an experienced radiology medical coding company can help practices optimize claim accuracy and streamline revenue cycle performance. In addition, using an AI-powered assistant such as MedGenX can support precise code selection, identify documentation gaps, and improve efficiency, enabling coders and providers to navigate the complexities of nuclear medicine billing with greater confidence. AI medical coding tools, combined with expert human review, help ensure consistent and accurate coding, optimize reimbursement, and maintain compliance in nuclear medicine claims submission.
Improve coding accuracy and reduce denials with MedGenx AI and expert review.
FAQs
What is the CPT code range for diagnostic nuclear medicine procedures?
Diagnostic nuclear medicine procedures are generally reported using CPT codes 78012–78999, which cover imaging studies involving various organ systems, including endocrine, gastrointestinal, cardiovascular, respiratory, nervous, and genitourinary systems.
Do nuclear medicine procedures require prior authorization?
Yes. Many diagnostic nuclear medicine procedures, especially high-cost studies such as PET scans, require prior authorization from insurers to establish medical necessity and ensure coverage.
What documentation is needed for nuclear medicine billing?
Claims should be supported by a physician order, clinical indications demonstrating medical necessity, details of the radiopharmaceutical administered, imaging findings, and a finalized interpretation report.
Are radiopharmaceuticals billed separately from the imaging procedure?
In many cases, radiopharmaceuticals are reported separately using HCPCS Level II codes. However, reimbursement policies vary by payer and care setting.
What are common billing challenges for nuclear medicine procedures?
Common challenges include selecting the correct CPT code, complying with NCCI edits, obtaining prior authorization, documenting medical necessity, and keeping up with annual CPT and payer policy changes.
How can AI medical coding tools improve nuclear medicine claims?
AI medical coding tools, combined with expert human review, can help identify appropriate codes, flag documentation gaps, improve coding consistency, and reduce claim denials while supporting compliance.
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