Question:

When coding for myocardial perfusion imaging using code 78453, what factors should be considered regarding the use of isotopes and the inclusion of wall motion, ejection fraction, and attenuation correction?

Answer:

This exam may be done at stress or rest but not both; for both, see multiple study CPT code. This myocardial perfusion imaging code is specifically for 2-D planar imaging. Single- or dual-isotope technique may be used. If 201Tl is used, it should be charged per millicurie (mCi) used. If 99mTc sestamibi or 99mTc tetrofosmin is used, charge per-study dose. This code includes wall motion, ejection fraction and attenuation correction when performed, either separately or as part of any of these myocardial perfusion studies. It may not be billed separately, but this would be rare and tips as noted under codes 78451 and 78452 apply.

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