Liver imaging with vasc flow
CPT code 78202 covers nuclear medicine imaging of the liver that includes evaluation of blood flow through the liver's vessels. This diagnostic test uses radioactive tracers to create images showing both liver structure and how blood circulates through it.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Document the vascular flow component separately from static imaging phases in the report, explicitly describing arterial and portal venous phase images
Impact: Prevents downcoding to 78201 (static liver imaging only) which pays approximately $30-40 less
Report the specific radiopharmaceutical used (typically Tc-99m sulfur colloid or Tc-99m RBC) with appropriate HCPCS code for proper cost recovery
Impact: Radiopharmaceutical costs of $50-150 are separately reimbursable and often missed on facility claims
Bill global code without modifiers when facility provides both technical and professional components to maximize reimbursement at $188.58
Impact: Splitting components unnecessarily may result in lower total payment due to rounding and administrative costs
Verify patient has not had barium studies within 48 hours prior, as residual barium creates artifacts and may require study cancellation
Impact: Prevents non-covered cancellation fees and wasted radiopharmaceutical costs averaging $75-100 per dose
Append modifier 26 consistently if you are reading studies performed at outside facilities to avoid Medicare overpayment audits
Impact: Prevents recoupment actions; professional component typically pays $40-60 of the total $188.58
When performed for hemangioma characterization, ensure prior anatomic imaging (CT/MRI/ultrasound) is documented in medical record to support medical necessity
Impact: Supports medical necessity and prevents denials; documentation deficiency is primary reason for 15-20% denial rate
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