Question:

We are confused about the coding for 78451 and 78452. Can you tell us what is the difference between single study myocardial perfusion SPECT (78451) and multiple studies SPECT (78452)? We have experienced problems when reporting 78451 twice.

Answer:

Understand that code 78451 is reported when a myocardial perfusion scan with SPECT imaging is performed ONLY at rest, or ONLY at stress. One dose of the radiopharmaceutical is given, and the exam is only performed once. Code 78452 is reported when two exams are performed, one is usually performed at rest, and it is repeated after stress. The patient is given two doses of the radiopharmaceutical, one for each study. The most common combination of exams is rest and stress, but rest and redistribution may be performed according to medical necessity. Both exams may be performed on the same day or on separate dates. If performed on separate dates, you should still report the combination code 78452 and not the individual code (78451) twice.

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