How to Bill CPT 45378 in Specialty Medical Practices

When to Use CPT Code 45378

CPT 45378 is commonly billed in specialty practices as part of diagnostic evaluation or procedural care.

• •Specialty use: Cardiology, dermatology, orthopedics, gastroenterology, ophthalmology, or ENT
• •Service type: Diagnostic test, procedure, or specialty visit
• •Who bills it: Specialists and qualified healthcare providers

Common scenarios:

• •Specialty diagnostic testing
• •In-office or outpatient procedures
• •Disease-specific evaluation and monitoring

Insurance Verification Tips for CPT 45378

1. •Verify specialty-specific coverage rules.
2. •Confirm prior authorization requirements.
3. •Apply appropriate modifiers when components are split.
4. •Ensure documentation reflects specialty-level complexity.

Example Case of CPT 45378

A specialist performs a diagnostic or procedural service appropriate to their specialty.
The service is documented and billed as one unit of CPT 45378.