Question:

When evaluating for sarcoidosis we perform both a perfusion PET scan and a metabolic evaluation. Can I report both 78491 and 78459?

Answer:

Prior to January 1, 2020, it is appropriate to report both positron emission tomography (PET) codes. However, beginning in 2020, a combined code should be reported instead of the individual codes. Code 78432 includes perfusion PET with metabolic evaluation. When a combined PET/CT is performed, report code 78433 instead of 78432. The code descriptions are as follows:

78432 Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);
78433 with concurrently acquired computed tomography transmission scan

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