How To Use CPT Code 78429

CPT 78429 describes the procedure for myocardial imaging using positron emission tomography (PET) with a concurrent computed tomography (CT) transmission scan. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78429?

CPT 78429 can be used to describe the procedure for myocardial imaging using PET with a concurrent CT transmission scan. This code is used when the provider performs a single study to evaluate the functioning of the heart muscle. The test provides information on metabolism, such as oxygen, glucose, or drug metabolism, and may include ejection fraction and ventricular wall motion studies if performed.

2. Official Description

The official description of CPT code 78429 is: ‘Myocardial imaging, positron emission tomography (PET), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan.’

3. Procedure

1. The provider injects a radioactive tracer into the patient’s bloodstream.
2. The radionuclide travels in the bloodstream and reaches the heart.
3. The radionuclide breaks into positrons, emitting gamma rays.
4. The PET and CT scanners detect the gamma rays emitted by the radioactive substance.
5. The computer processes the emitted data to produce multidimensional images of the distribution of the tracer throughout the heart muscle.
6. The provider evaluates the metabolic function of the heart and may assess ventricular wall motion and ejection fraction.
7. The CT and PET data are fused and presented to the interpreter for analysis.

4. Qualifying circumstances

Patients eligible to undergo CPT 78429 are those who require myocardial imaging for diagnostic purposes. This procedure is typically performed to evaluate the functioning of the heart muscle and assess metabolic activity. The provider must use a concurrent CT transmission scan to help determine whether the observed activity is physiologic or pathologic. The procedure may also involve the evaluation of ventricular wall motion and ejection fraction.

5. When to use CPT code 78429

CPT code 78429 should be used when a provider performs a myocardial imaging study using PET with a concurrent CT transmission scan. This code is appropriate for a single study and should be reported when evaluating the metabolic function of the heart and assessing ventricular wall motion and ejection fraction, if performed.

6. Documentation requirements

To support a claim for CPT 78429, the provider must document the following information:

• Reason for the myocardial imaging study
• Details of the radioactive tracer used
• Date and time of the procedure
• Findings from the PET and CT scans
• Evaluation of ventricular wall motion and ejection fraction, if performed
• Interpretation of the images and any additional observations
• Signature of the interpreting provider

7. Billing guidelines

When billing for CPT 78429, ensure that the procedure includes both PET imaging and a concurrent CT transmission scan. The provider should report this code for a single study. It is important to follow payer guidelines and append the appropriate modifiers, such as modifier 26 for the professional component or modifier TC for the technical component, if applicable. It is also essential to review payer policies regarding the reporting of radiopharmaceutical supply separately.

8. Historical information

CPT 78429 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a myocardial imaging study using PET with a concurrent CT transmission scan to evaluate the metabolic function of their heart and assess ventricular wall motion.
2. A provider performs a single study of myocardial imaging using PET with a concurrent CT transmission scan to determine the oxygen metabolism in a patient’s heart.
3. During a myocardial imaging study using PET with a concurrent CT transmission scan, the provider evaluates the glucose metabolism and assesses the ejection fraction of a patient’s heart.
4. A patient undergoes a myocardial imaging study using PET with a concurrent CT transmission scan to assess the ventricular wall motion and evaluate the drug metabolism in their heart.
5. A provider performs a single study of myocardial imaging using PET with a concurrent CT transmission scan to evaluate the mitochondrial function and assess the ejection fraction of a patient’s heart.
6. During a myocardial imaging study using PET with a concurrent CT transmission scan, the provider assesses the fatty acid uptake and evaluates the ventricular wall motion of a patient’s heart.
7. A patient undergoes a myocardial imaging study using PET with a concurrent CT transmission scan to evaluate the amino acid effects on their heart and assess the ejection fraction.
8. A provider performs a single study of myocardial imaging using PET with a concurrent CT transmission scan to determine the glucose metabolism and assess the ventricular wall motion of a patient’s heart.
9. During a myocardial imaging study using PET with a concurrent CT transmission scan, the provider evaluates the drug metabolism and assesses the ejection fraction of a patient’s heart.
10. A patient undergoes a myocardial imaging study using PET with a concurrent CT transmission scan to assess the mitochondrial function and evaluate the ventricular wall motion in their heart.