A: Currently, CPT® code 79000 (Radiopharmaceutical therapy, hyperthyroidism; initial, including evaluation of patient) is used to report the initial therapeutic dose of I-131 in the treatment of hyperthyroidism. As noted in the descriptor, evaluation of the patient is included in the procedure and is not coded separately. However, the type of radiopharmaceutical supply used is reported separately with a HCPCS Level II code (e.g., A9517, A9530) or CPT® code 79900 (Provision of therapeutic radiopharmaceutical(s)).
As of January 1, 2005, submit code 79005 (Radiopharmaceutical therapy, by oral administration) to report the treatment of hyperthyroidism with an orally administered dose of I-131 sodium iodide. Note that unlike 79000 (Radiopharmaceutical therapy, hyperthyroidism; initial, including evaluation of patient), which includes the evaluation of the patient, neither 79005 nor any of the other therapeutic codes include evaluation and management services. Although dose calculation and a discussion of risks and benefits of radiotherapy are included in CPT® code 79005, it is appropriate to report an evaluation and management code when additional services are provided and documented related to the clinical workup of the patient and the decision to treat with radioiodine. Evaluation and management code selection should be in compliance with CPT® requirements. In 2005, a HCPCS Level II code should be submitted to all payers to report the radiopharmaceutical supply used since the CPT® codes 78990 and 79900 have been deleted from the CPT® book. Check Medicare and other third-party payer notifications on their guidelines for the use of these codes.
Note that if a second treatment dose of I-131 for hyperthyroidism needs to be given, there is no code to describe an additional dose, as previously described by 79001(subsequent, each therapy); therefore, reporting of 79005 (Radiopharmaceutical therapy, by oral administration) for the second therapeutic dose of I-131 would be appropriate.