How To Use CPT Code 78451

CPT 78451 describes the procedure of myocardial perfusion imaging using single photon emission computerized tomography (SPECT) to assess blood flow in the heart. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78451?

CPT 78451 can be used to describe the procedure of myocardial perfusion imaging using SPECT. This imaging technique involves the use of a radioactive substance and a special camera to produce three-dimensional images of the heart. The purpose of this procedure is to identify areas of the heart that have deficient blood supply, known as ischemia.

2. Official Description

The official description of CPT code 78451 is: ‘Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic).’ It is important to note that this code should not be reported in conjunction with certain other codes, as specified in the notes.

3. Procedure

1. During the procedure, the provider performs a single SPECT study of the heart to assess blood flow.
2. The patient may undergo the study at rest or undergo stress-inducing activities, such as exercise on a bicycle or treadmill, or the administration of a vasodilator.
3. A radionuclide substance is injected into the patient, which collects in the nonischemic tissues of the heart.
4. The provider then takes SPECT images of the heart to identify areas with poor blood supply.

4. Qualifying circumstances

CPT 78451 is used for patients who require myocardial perfusion imaging to assess blood flow in the heart. This procedure is typically performed on patients with suspected or known ischemic heart disease. The provider must use SPECT imaging and may need to perform additional assessments, such as attenuation correction, qualitative or quantitative wall motion analysis, and ejection fraction measurement.

5. When to use CPT code 78451

CPT code 78451 should be used when a provider performs a single study of myocardial perfusion imaging using SPECT. This study can be conducted at rest or during stress-inducing activities. It is important to note that this code should not be reported in conjunction with certain other codes, as specified in the notes.

6. Documentation requirements

To support a claim for CPT 78451, the provider must document the following information:

• Patient’s medical history and indication for the procedure
• Type of SPECT imaging performed (rest or stress)
• Date and time of the procedure
• Details of any additional assessments performed, such as attenuation correction, qualitative or quantitative wall motion analysis, and ejection fraction measurement
• Findings and interpretation of the myocardial perfusion imaging
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 78451, ensure that the procedure meets the criteria outlined in the official description. It is important to note that this code should not be reported in conjunction with certain other codes, as specified in the notes. Additionally, there may be specific guidelines and modifiers to consider based on payer policies and whether the provider is reporting the professional or technical component of the service.

8. Historical information

CPT 78451 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a single study of myocardial perfusion imaging using SPECT at rest to assess blood flow in the heart.
2. A patient undergoes a single study of myocardial perfusion imaging using SPECT during a stress test on a treadmill to evaluate blood flow in the heart.
3. A patient undergoes a single study of myocardial perfusion imaging using SPECT after the administration of a vasodilator to assess blood flow in the heart.
4. A patient undergoes a single study of myocardial perfusion imaging using SPECT at rest, with additional quantification and ejection fraction measurement.
5. A patient undergoes a single study of myocardial perfusion imaging using SPECT during a stress test on a bicycle, with qualitative wall motion analysis.
6. A patient undergoes a single study of myocardial perfusion imaging using SPECT at rest, with attenuation correction and quantitative wall motion analysis.
7. A patient undergoes a single study of myocardial perfusion imaging using SPECT during a stress test with a vasodilator, with additional quantification and ejection fraction measurement.
8. A patient undergoes a single study of myocardial perfusion imaging using SPECT at rest, with attenuation correction and wall motion analysis.
9. A patient undergoes a single study of myocardial perfusion imaging using SPECT during a stress test on a treadmill, with additional quantification and ejection fraction measurement.
10. A patient undergoes a single study of myocardial perfusion imaging using SPECT at rest, with qualitative wall motion analysis and ejection fraction measurement.