1 Billing for the radiopharmaceutical agents: 1. Radiopharmaceuticals are available in unit dose or in bulk doses, the latter requiring preparation at the. imaging center. Use of radiopharmaceuticals is regulated by the Nuclear Regulatory Commission (NRC) under strict procedures and guidelines.
https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/31072_1/L31072_cv017_cbg.pdf
myocardial perfusion imaging, preceded by satisfactory stress echocardiography (CPT code 93350), is not medically necessary. Cardiac Blood Pool Imaging (CPT codes 78472, 78473, 78481, 78483, 78494, 78496) These services are allowed for the evaluation of ventricular size, wall motion, stroke volume, and ejection fraction when this information is medically necessary to direct further. evaluation and management of the cardiac condition.
http://www.radmd.com/assets/Clinical%20Guidelines/MedicareClinicalGuidelines/Palmetto%20GBA;%20J-11%20(NC,%20SC,%20VA,%20WV)/MPI_MUGA%20CMS%20L31700%20J11%20(NC%20SC%20VA%20WV).pdf
Only one professional component (26) may be billed for the primary service performed. If a radiologist. performs the professional component of the myocardial perfusion imaging (78451-26), then only the. radiologist may bill for the professional service.
https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/31072_1/L31072_cv017_cbg.pdf
Myocardial Perfusion Imaging (CPT codes 78451-78454, 78491, 78492) Patients with a high pretest probability of disease are usually not candidates for this study unless determination of the size and reversibility of a defect are required for clinical decision making. Patients whose diagnosis is in question benefit most from this study.
http://www.radmd.com/assets/Clinical%20Guidelines/MedicareClinicalGuidelines/Palmetto%20GBA;%20J-11%20(NC,%20SC,%20VA,%20WV)/MPI_MUGA%20CMS%20L31700%20J11%20(NC%20SC%20VA%20WV).pdf
Myocardial perfusion and blood pool imaging require general supervision by a qualified physician licensed to administer radioactive materials. Cardiology stress procedures (CPT codes 93015-93018) performed in conjunction with nuclear myocardial perfusion imaging studies are covered by Medicare only when performed under the direct supervision of a
http://www.radmd.com/assets/Clinical%20Guidelines/MedicareClinicalGuidelines/Palmetto%20GBA;%20J-11%20(NC,%20SC,%20VA,%20WV)/MPI_MUGA%20CMS%20L31700%20J11%20(NC%20SC%20VA%20WV).pdf
The two types of radionuclide studies commonly used for cardiac evaluation are myocardial. perfusion imaging and ventriculography. Myocardial perfusion imaging is used primarily. for the evaluation of coronary artery disease.
http://www.radmd.com/assets/Clinical%20Guidelines/MedicareClinicalGuidelines/Palmetto%20GBA;%20J-11%20(NC,%20SC,%20VA,%20WV)/MPI_MUGA%20CMS%20L31700%20J11%20(NC%20SC%20VA%20WV).pdf
dipyridamole or adenosine. Use of pharmacologic agents in myocardial perfusion imaging (CPT codes 78451-78454) is not a standard of care and is not medically necessary unless exercise is not possible. In some cases dobutamine may be used to effect stress through its inotropic effect. 1.
http://www.radmd.com/assets/Clinical%20Guidelines/MedicareClinicalGuidelines/Palmetto%20GBA;%20J-11%20(NC,%20SC,%20VA,%20WV)/MPI_MUGA%20CMS%20L31700%20J11%20(NC%20SC%20VA%20WV).pdf
Cardiac blood pool imaging: There are two types of studies: first pass studies and equilibrium studies. First pass Studies (CPT codes 78481 and 78483) First pass studies utilize rapidly acquired images of a bolus of a radiopharmaceutical agent as it. moves through the heart.
https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/31072_1/L31072_cv017_cbg.pdf
Coding and Billing Guidelines: LCD Database ID Number L31072 LCD Title Myocardial Perfusion Imaging and Cardiac Blood Pool Studies Contractor's Determination Number CV-017 A. Use the appropriate CPT code, 78451 – 78496, to describe the primary service performed, including whether it is a single study or multiple studies. B. An ICD-9-CM code supporting the medical necessity for the service must be submitted with each
https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/31072_1/L31072_cv017_cbg.pdf
Myocardial Perfusion Imaging (CPT codes 78451-78454, 78491, 78492) Patients with a high pretest probability of disease are usually not candidates for this study. unless determination of the size and reversibility of a defect are required for clinical. decision making.
http://www.radmd.com/assets/Clinical%20Guidelines/MedicareClinicalGuidelines/Palmetto%20GBA;%20J-11%20(NC,%20SC,%20VA,%20WV)/MPI_MUGA%20CMS%20L31700%20J11%20(NC%20SC%20VA%20WV).pdf
what is cpt code for myocardial perfusion study
Current Procedural Terminology codes for myocardinal perfusion study are 78451, 78452, 78453, 78453, 78491, and 78492. 78451 78454, 78491,and 78492 are the CPT codes for myocardial perfusion study.