Certified Professional Coder (CPC) Quiz: Code Radiation And Nuclear Medicine
20 questions · exam conditions
0:00
Code Radiation And Nuclear MedicineQuestion 1 of 20

Which CPT® code is reported for this PET/CT scan from skull base to mid-thigh?

78812
78815
78816
78814
← Back to quizzes

Certified Professional Coder (CPC) Quiz

Certified Professional Coder (CPC) Quiz: Code Radiation And Nuclear Medicine

Practice Code Radiation And Nuclear Medicine in Certified Professional Coder (CPC) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Code Radiation And Nuclear Medicine, giving you a quick way to practice the rules, question types, and explanations that matter most for Certified Professional Coder (CPC).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

Which CPT® code is reported for this PET/CT scan from skull base to mid-thigh?

  1. 78812
  2. 78815 (correct answer)
  3. 78816
  4. 78814
Explanation: CPT® 78815 describes PET/CT imaging of the skull base to mid-thigh — the correct code for the standard oncologic staging or restaging FDG-PET/CT scan performed from skull base to mid-thigh using a combined imaging platform that provides both metabolic and anatomic data. Code 78812 describes PET (without CT) imaging from skull base to mid-thigh, using PET alone without a concurrent CT; combined PET/CT requires 78815. Code 78816 describes PET/CT for whole-body imaging extending beyond mid-thigh to the toes. Code 78814 describes PET/CT for a limited area (not skull base to mid-thigh). The PET/CT series (78814-78816) should be used in place of the PET-only codes (78811-78813) when CT is performed concurrently as an integral part of the study.

Question 2

Which CPT® code is reported for superficial or orthovoltage radiation treatment delivery?

  1. 77402
  2. 77407
  3. 77401 (correct answer)
  4. 77412
Explanation: CPT® 77401 describes radiation treatment delivery, superficial and/or orthovoltage, ≤250 kV — the correct code for radiation therapy delivered with low-energy x-ray beams (superficial 50-150 kV or orthovoltage 150-500 kV) used to treat superficial skin lesions such as basal cell carcinoma and squamous cell carcinoma. Code 77402 describes simple radiation treatment delivery at ≥1 MeV (megavoltage) energy; the 100 kV beam used here is orthovoltage, below the megavoltage threshold. Code 77407 describes intermediate megavoltage (≥1 MeV) radiation treatment delivery. Code 77412 describes complex megavoltage radiation treatment delivery. The kilovoltage threshold — ≤250 kV (superficial/orthovoltage, code 77401) versus ≥1 MeV (megavoltage, codes 77402/77407/77412) — is the primary differentiator.

Question 3

Which CPT® code is reported for intraoperative radiation treatment delivery using electrons?

  1. 77424
  2. 77425 (correct answer)
  3. 77469
  4. 77412
Explanation: CPT® 77425 describes intraoperative radiation treatment delivery, electrons — the correct code for IORT administered using an electron beam delivered directly to the tumor bed during open surgery. Code 77424 describes intraoperative radiation treatment delivery using x-rays at ≤1 MeV energy (low-energy x-ray IORT, such as the Intrabeam system); electrons are used here, requiring 77425. Code 77469 describes intraoperative radiation treatment management (the physician management component of IORT, reported separately from delivery). Code 77412 describes complex external beam radiation treatment delivery (megavoltage), which is a standard fractionated treatment, not intraoperative radiation. IORT delivery codes distinguish between x-ray (77424) and electron (77425) energy sources; the management of each IORT fraction is separately reported with 77469.

Question 4

Which CPT® code is reported for quantitative differential pulmonary perfusion and ventilation imaging with SPECT acquisition?

  1. 78582
  2. 78580
  3. 78598 (correct answer)
  4. 78579
Explanation: CPT® 78598 describes pulmonary ventilation and perfusion imaging (V/Q), quantitative differential, SPECT — the correct code when the V/Q study specifically includes SPECT acquisition AND provides quantitative regional (differential) lung function data (e.g., percentage of total ventilation or perfusion per lung zone), used for presurgical lung function planning or radiotherapy planning. Code 78582 describes planar ventilation and perfusion (V/Q) imaging; when SPECT acquisition and quantitative differential data are required, 78598 is the specific code. Code 78580 describes perfusion-only planar imaging (no ventilation and no SPECT). Code 78579 describes ventilation-only imaging. The distinction between 78582 (standard planar V/Q) and 78598 (quantitative differential V/Q with SPECT) rests on both the acquisition method (SPECT vs. planar) and the level of quantitative analysis (differential quantification vs. standard qualitative interpretation).

Question 5

Which CPT® code is reported for the complete course of stereotactic cranial radiation treatment management?

  1. 77435
  2. 77427
  3. 77432 (correct answer)
  4. 77412
Explanation: CPT® 77432 describes stereotactic radiation treatment management of cranial lesion(s), complete course of treatment — the correct code for the physician's complete management of cranial stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) to intracranial targets, regardless of the number of fractions. Code 77432 is reported once for the entire course, not per fraction. Code 77435 describes stereotactic body radiation therapy (SBRT) treatment management for extracranial targets (lung, liver, spine, prostate) — an extracranial code not applicable to intracranial SRS. Code 77427 describes conventional radiation treatment management per 5 treatments — used for standard fractionated therapy, not for single-session or hypofractionated cranial SRS. Code 77412 describes radiation treatment delivery (complex), a technical delivery code. Cranial SRS/SRT management uses 77432; extracranial SBRT management uses 77435.

Question 6

Which CPT® code is reported for a planar ventilation and perfusion (V/Q) lung scan?

  1. 78580
  2. 78579
  3. 78598
  4. 78582 (correct answer)
Explanation: CPT® 78582 describes pulmonary ventilation and perfusion imaging, planar — the correct code for a combined V/Q scan in which both ventilation (aerosol) and perfusion (Tc-99m MAA) planar images are acquired and interpreted together for pulmonary embolism evaluation. Code 78580 describes pulmonary perfusion imaging only (no ventilation component); since both ventilation and perfusion are performed here, 78582 is required. Code 78579 describes pulmonary ventilation imaging only (no perfusion component). Code 78598 describes quantitative differential pulmonary perfusion and ventilation imaging including SPECT acquisition — a more advanced study than standard planar V/Q imaging. When both ventilation and perfusion planar imaging are performed in the same session, a single code (78582) is used rather than reporting 78579 and 78580 separately.

Question 7

Which CPT® code is reported for FDG-PET brain imaging for metabolic evaluation?

  1. 78609
  2. 78600
  3. 78607
  4. 78608 (correct answer)
Explanation: CPT® 78608 describes PET brain imaging, metabolic evaluation — the correct code for FDG (F-18 fluorodeoxyglucose) PET brain imaging used to assess regional cerebral glucose metabolism for the evaluation of dementia, epilepsy, and other neurological conditions. Hypometabolism patterns on FDG-PET help differentiate Alzheimer disease from frontotemporal dementia and Lewy body disease. Code 78609 describes PET brain imaging, perfusion evaluation — used for blood flow assessment (e.g., with N-13 ammonia or O-15 water), not glucose metabolism. Code 78600 describes planar brain imaging (non-PET, conventional nuclear medicine); this is PET imaging. Code 78607 describes SPECT brain imaging; SPECT is a different technology from PET, using different radiopharmaceuticals and providing lower resolution images. FDG-PET brain metabolic imaging is reported with 78608.

Question 8

Which CPT® code is reported for this whole-body bone scan?

  1. 78300
  2. 78305
  3. 78306 (correct answer)
  4. 78315
Explanation: CPT® 78306 describes bone and/or joint imaging, whole body — the correct code for a planar whole-body nuclear medicine bone scan acquired from skull to feet using a bone-seeking radiopharmaceutical such as Tc-99m MDP. Code 78300 describes bone imaging of a limited area (one specific anatomic region, such as the spine or pelvis only); whole-body acquisition requires 78306. Code 78305 describes bone imaging of multiple areas (more than one region but not whole body). Code 78315 describes bone and/or joint imaging with SPECT (tomographic acquisition); planar (not SPECT) images are acquired here. Whole-body (78306) versus limited area (78300) versus multiple areas (78305) is determined by the anatomic coverage; the addition of SPECT tomographic acquisition upgrades the code to 78315.

Question 9

Which CPT® code is reported for kidney imaging morphology with vascular flow?

  1. 78700
  2. 78701 (correct answer)
  3. 78707
  4. 78710
Explanation: CPT® 78701 describes kidney imaging, morphology, with vascular flow — the correct code when renal scintigraphy includes both vascular flow (dynamic images obtained immediately post-injection) and delayed static morphologic images. Code 78700 describes kidney imaging, morphology, static only, without vascular flow; since vascular flow imaging is specifically performed here, 78701 is required. Code 78707 describes kidney imaging with morphology and function, with or without pharmacological intervention — a more comprehensive study that includes both morphology and quantitative function (split renal function, GFR estimation), not just morphology and flow. Code 78710 describes renal SPECT imaging (tomographic), not planar vascular flow imaging. The addition of vascular flow differentiates 78701 from the static-only code 78700.

Question 10

Which CPT® code is reported for remote afterloading HDR intracavitary brachytherapy for 1 to 4 fractions?

  1. 77763
  2. 77761
  3. 77772
  4. 77770 (correct answer)
Explanation: CPT® 77770 describes remote afterloading high dose rate (HDR) intracavitary brachytherapy, 1 to 4 fractions — the correct code when HDR brachytherapy is delivered intracavitarily (e.g., cervical, endometrial, or esophageal applicator) using a remote afterloading system for 1 to 4 fractions. Code 77771 describes HDR intracavitary brachytherapy for 5 to 8 fractions; the treatment course described has not reached 5 fractions at the time of reporting. Code 77772 describes HDR intracavitary brachytherapy for more than 8 fractions. Code 77767 describes remote afterloading HDR skin surface brachytherapy (1-4 fractions) — used for superficial skin lesions treated with surface applicators, not for intracavitary placement. Code 77763 describes manual (non-remote afterloading) complex intracavitary brachytherapy using low dose rate sources. The anatomic site (intracavitary vs. skin surface) and fraction count (1-4, 5-8, >8) together select the correct HDR brachytherapy code.

Question 11

Which CPT® code is reported for the complete course of SBRT treatment management (extracranial)?

  1. 77435 (correct answer)
  2. 77432
  3. 77427
  4. 77412
Explanation: CPT® 77435 describes stereotactic body radiation therapy (SBRT) treatment management, per treatment course, to one or more lesions, including image guidance — the correct code for the physician's complete management of extracranial SBRT (lung, liver, spine, prostate, adrenal, etc.), reported once per treatment course regardless of the number of fractions. Code 77432 describes stereotactic cranial radiation treatment management (Gamma Knife or linac-based intracranial SRS/SRT); SBRT targets the lung, which is extracranial, requiring 77435. Code 77427 describes conventional radiation treatment management per 5 treatments — used for standard fractionated therapy, not per-course reporting. Code 77412 describes complex radiation treatment delivery — a technical delivery code, not a management code. SBRT management (77435, extracranial) and SRS management (77432, cranial) are reported once per complete treatment course.

Question 12

Which CPT® code is reported for this whole-body PET/CT scan extending from skull to toes?

  1. 78813
  2. 78815
  3. 78812
  4. 78816 (correct answer)
Explanation: CPT® 78816 describes combined PET/CT imaging, whole body — the correct code for a PET/CT scan that covers the entire body including the lower extremities beyond the mid-thigh, acquired on a combined PET/CT scanner. Code 78815 describes PET/CT from skull base to mid-thigh — the standard oncologic staging scan that does not extend to the feet; this scan extends to the toes, requiring 78816. Code 78813 describes PET-only (no concurrent CT) whole-body imaging; combined PET/CT requires the PET/CT-specific codes (78814-78816). Code 78812 describes PET-only imaging, skull base to mid-thigh. In lymphoma staging and restaging, whole-body PET/CT (78816) is preferred to ensure the extremities are included. The anatomic coverage — skull base to mid-thigh (78815) versus whole body including lower extremities (78816) — differentiates these codes.

Question 13

Which CPT® code is reported for complex radiation treatment delivery at ≥1 MeV?

  1. 77412 (correct answer)
  2. 77402
  3. 77407
  4. 77401
Explanation: CPT® 77412 describes radiation treatment delivery, complex, ≥1 MeV — the correct code for megavoltage radiation delivery when the treatment involves three or more treatment ports, custom blocks or tissue compensators, and complex planning requirements. Code 77402 describes simple radiation treatment delivery (≥1 MeV) for one or two treatment ports with no custom shielding; the multiple-port, compensated field arrangement described here does not qualify as simple. Code 77407 describes intermediate radiation treatment delivery (≥1 MeV) for three or more treatment ports or two ports with custom shielding. Code 77401 describes radiation treatment delivery at superficial or orthovoltage energy (≤250 kV), used for skin lesions; megavoltage (≥1 MeV) energy is used for deep-seated targets. The complexity classification — simple (77402), intermediate (77407), or complex (77412) — is determined by the number of ports, use of custom shielding, and field complexity.

Question 14

Which CPT® code is reported for a single-phase gastric emptying imaging study?

  1. 78265
  2. 78264 (correct answer)
  3. 78262
  4. 78266
Explanation: CPT® 78264 describes gastric emptying imaging study, single-phase — the correct code for a standard gastric emptying scan using a radiolabeled solid, liquid, or dual-phase meal with image acquisition at defined intervals and calculation of the emptying half-time. Code 78265 describes a dual-phase gastric emptying study in which both solid and liquid phases are imaged and analyzed simultaneously or sequentially; only a single-phase (solid) study is performed here. Code 78262 describes gastroesophageal reflux imaging, which evaluates reflux of gastric contents into the esophagus — not the same as gastric emptying. Code 78266 describes a three-phase gastric emptying study. Single (78264), dual (78265), and triple-phase (78266) gastric emptying studies are differentiated by the number of distinct meal phases analyzed.

Question 15

Which CPT® code is reported for radiopharmaceutical therapy by radiolabeled monoclonal antibody IV infusion?

  1. 79005
  2. 79101
  3. 79200
  4. 79403 (correct answer)
Explanation: CPT® 79403 describes radiopharmaceutical therapy by radiolabeled monoclonal antibody by intravenous infusion — the correct code for immunotherapy using antibodies labeled with therapeutic radioisotopes (such as Y-90 ibritumomab tiuxetan), which combine targeted antibody delivery with beta-particle radiation. Code 79101 describes radiopharmaceutical therapy by general intravenous administration — used for IV radiopharmaceuticals that are not monoclonal antibodies; a specific code (79403) exists for radiolabeled antibody infusions and takes precedence. Code 79005 describes oral radiopharmaceutical therapy (e.g., oral I-131). Code 79200 describes intracavitary radiopharmaceutical therapy. When a therapeutic radiopharmaceutical is specifically a radiolabeled monoclonal antibody administered intravenously, 79403 is the applicable code rather than the general IV therapy code 79101.

Question 16

Which CPT® code is reported for parathyroid SPECT/CT imaging?

  1. 78070
  2. 78071
  3. 78015
  4. 78072 (correct answer)
Explanation: CPT® 78072 describes parathyroid planar imaging with SPECT/CT — the correct code for parathyroid scintigraphy that includes SPECT/CT acquisition, providing both functional radionuclide localization and anatomic CT-based correlation in a single session. Code 78070 describes parathyroid planar imaging only (no SPECT or CT); planar images alone are insufficient when SPECT/CT is performed. Code 78071 describes parathyroid planar imaging combined with SPECT (without CT); SPECT/CT (with CT component) requires 78072, which supersedes 78071. Code 78015 describes parathyroid planar imaging only (equivalent to 78070 in some code sets). The addition of CT to SPECT (making SPECT/CT) represents a more complex, anatomically precise study captured by 78072. When SPECT/CT is performed, the SPECT/CT-specific code (78072) is used instead of reporting 78071 plus a separate CT code.

Question 17

Which CPT® code is reported for complex proton beam treatment delivery?

  1. 77525 (correct answer)
  2. 77520
  3. 77523
  4. 77522
Explanation: CPT® 77525 describes proton treatment delivery, complex — the correct code for complex proton beam therapy involving multiple treatment areas, special beam arrangements, and/or the use of compensating devices requiring intensive dosimetric planning. Code 77520 describes simple proton treatment delivery without compensation; this is a complex treatment with compensating bolus and multiple fields. Code 77523 describes intermediate proton treatment delivery. Code 77522 describes simple proton treatment delivery with compensation (compensating bolus used but still simple in other respects); the treatment here meets complex criteria. Proton therapy delivery codes parallel the photon delivery codes: simple (77520/77522), intermediate (77523), and complex (77525), with the key differentiator being the complexity of beam arrangements, compensating devices, and field configurations.

Question 18

Which CPT® code is reported for intermediate radiation treatment planning?

  1. 77261
  2. 77263
  3. 77262 (correct answer)
  4. 77295
Explanation: CPT® 77262 describes therapeutic radiology treatment planning, intermediate — the correct code when the planning effort involves moderate complexity, such as multiple anatomic areas or the use of some compensating techniques, falling between the simple and complex thresholds. Code 77261 describes simple radiation treatment planning for a single area with minimal technical complexity. Code 77263 describes complex radiation treatment planning involving advanced techniques; the description here places the plan at the intermediate level. Code 77295 describes preparation of a three-dimensional (3D-CRT) conformal treatment plan, which is a specific service distinct from the clinical complexity planning codes; 77262 and 77263 assess clinical and technical planning complexity, while 77295 specifically describes 3D volumetric planning dosimetry.

Question 19

Which CPT® code is reported for hepatobiliary imaging with pharmacologic intervention (sincalide) including quantification of gallbladder ejection fraction?

  1. 78223
  2. 78201
  3. 78227 (correct answer)
  4. 78226
Explanation: CPT® 78227 describes hepatobiliary ductal system imaging including gallbladder, with pharmacologic intervention (e.g., sincalide/CCK), with quantification of gallbladder ejection fraction — the correct code when a pharmacologic stimulus is added to the HIDA scan AND gallbladder ejection fraction (GBEF) is measured and reported. Code 78226 describes hepatobiliary ductal system imaging with pharmacologic intervention but WITHOUT quantification of gallbladder ejection fraction; since ejection fraction is measured here, 78227 is required over 78226. Code 78223 describes standard hepatobiliary ductal system imaging without pharmacologic intervention and without quantification. Code 78201 describes liver imaging only (static), without biliary ductal system or gallbladder evaluation. Both pharmacologic intervention and ejection fraction quantification must be documented to support 78227; 78226 applies when sincalide is administered but GBEF is not calculated.

Question 20

Which CPT® code is reported for this myocardial perfusion SPECT study with both rest and stress acquisitions?

  1. 78452 (correct answer)
  2. 78451
  3. 78492
  4. 78453
Explanation: CPT® 78452 describes myocardial perfusion imaging, tomographic (SPECT), multiple studies, at rest and/or stress (exercise and/or pharmacologic) and redistribution and/or rest injection — the correct code when SPECT acquisition is performed at both rest and under stress (pharmacologic or exercise), yielding two tomographic studies for comparison. Code 78451 describes SPECT myocardial perfusion imaging for a single study (rest only or stress only); since both rest and stress acquisitions are performed here, 78452 is required. Code 78492 describes PET myocardial perfusion imaging, multiple studies (rest and stress); SPECT (not PET) technology is used here. Code 78453 describes planar (not SPECT) myocardial perfusion imaging, single study. SPECT versus planar technique and single versus multiple acquisition sessions are the two axes differentiating the myocardial perfusion imaging codes.