CPT 78708Radiology

K flow/funct image w/drug

CPT code 78708 covers a specialized kidney scan that uses a radioactive tracer to measure both blood flow and function after administering a drug (like a diuretic or ACE inhibitor) to assess how well the kidneys respond.

Showing rates for

National Average

Base Medicare rate

$170.47

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

Work RVU

1.21

PE RVU (NF)

3.97

MP RVU

0.09

Total RVU

5.27

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document the specific pharmacological agent administered (furosemide, captopril, etc.), dosage, timing, and clinical indication for the intervention
Impact: Essential for claim approval; missing drug documentation is the #1 cause of denials, potentially losing the full $170.47 reimbursement
Verify that both flow and function images are acquired and documented in the report; static function-only images should be coded differently (78707)
Impact: Coding 78708 without flow imaging may result in downcoding to 78707, reducing reimbursement by approximately $20-30
Bill globally (no modifier) when providing both technical and professional components in private practice setting to capture full $170.47
Impact: Splitting components unnecessarily can delay payment and create reconciliation issues worth the full allowed amount
Ensure radiopharmaceutical administration is documented separately with appropriate HCPCS codes (A9562 for Tc-99m MAG3, A9539 for Tc-99m DTPA) for cost recovery
Impact: Radiopharmaceutical costs typically $150-300 and are reimbursed separately; failure to bill these codes results in significant loss
Submit study with ICD-10 codes specifying the clinical indication (N13.30 for hydronephrosis, I15.0 for renovascular hypertension) to support medical necessity
Impact: Non-specific diagnosis codes trigger prior authorization requirements or denials, delaying payment by 30-60 days
For Medicare claims, verify LCD requirements for your jurisdiction regarding captopril renography versus other interventions
Some MACs have specific coverage criteria that may affect the 5.27 RVUs; non-compliance can result in full denial

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 78708 in 2025?

The 2025 Medicare national average reimbursement for CPT 78708 is $170.47 for both facility and non-facility settings. This is based on 5.27 total RVUs (1.21 work RVU + 3.97 PE RVU + 0.09 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 78708 and 78707?

CPT 78708 includes both flow (perfusion) and function imaging with pharmacological intervention (drug administration), while 78707 includes only flow and function imaging without any drug intervention. The intervention component in 78708 (using agents like furosemide or captopril) allows assessment of how the kidneys respond to physiological stress and justifies the additional complexity and reimbursement.

What drugs are commonly used for the pharmacological intervention in CPT 78708?

The most common interventions are furosemide (Lasix) for diuretic renography to assess urinary obstruction versus dilation, and captopril (or other ACE inhibitors) for captopril renography to diagnose renovascular hypertension. Other agents may include dopamine for assessment of renal reserve or hydration challenges for specific indications.

Can CPT 78708 be billed bilaterally or does it cover both kidneys?

CPT 78708 is inherently a bilateral procedure that includes imaging of both kidneys in a single study; it should not be billed twice for bilateral imaging. The code is billed once regardless of whether one or both kidneys are evaluated, though unilateral studies due to single kidney or technical limitations should be documented and may warrant modifier 52 for reduced service.

What ICD-10 codes are commonly used with CPT 78708?

Common diagnosis codes include N13.30 (unspecified hydronephrosis), N13.6 (pyonephrosis), I15.0 (renovascular hypertension), N28.0 (ischemia and infarction of kidney), Z94.0 (kidney transplant status), Q62.11 (congenital ureteropelvic junction obstruction), and N18.9 (chronic kidney disease, unspecified stage). The specific diagnosis must support the medical necessity for drug intervention imaging.

How do you bill for the radiopharmaceutical used in CPT 78708?

The radiopharmaceutical is billed separately using HCPCS codes: A9562 for Tc-99m mertiatide (MAG3) or A9539 for Tc-99m pentetate (DTPA). Bill the appropriate number of units based on the millicurie dose administered. CPT 78708 covers only the imaging service and pharmacological intervention, not the radiotracer itself.

Does CPT 78708 require prior authorization from Medicare or commercial payers?

Prior authorization requirements vary by payer and jurisdiction. Medicare Advantage plans and many commercial insurers increasingly require prior authorization for nuclear medicine studies including 78708. Original Medicare typically does not require prior authorization but does require medical necessity documentation. Always verify specific payer requirements before scheduling to avoid denials.