How To Use CPT Code 78453

CPT 78453 describes a diagnostic nuclear medicine procedure on the cardiovascular system. 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 78453?

CPT 78453 is a diagnostic nuclear medicine procedure used to assess the cardiovascular system. It involves performing a single planar study of the heart to determine areas of deficient blood flow. The goal of this procedure is to identify regions with poor blood supply by obtaining two-dimensional images.

2. Official Description

The official description of CPT code 78453 is: ‘Myocardial perfusion imaging, planar (including 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).’

3. Procedure

1. During the procedure, the healthcare provider administers a radionuclide substance to the patient, which collects in nonischemic tissues.
2. The provider then takes planar images of the heart to identify areas with poor blood supply.
3. A single planar study is performed either at rest or under stress. Stress can be induced through exercise on a bicycle or treadmill, or by administering a vasodilator to increase blood flow.

4. Qualifying circumstances

CPT 78453 is used for patients who require assessment of their cardiovascular system. It is typically performed on individuals with suspected ischemia, which refers to deficient blood supply in the body organs, most commonly the heart. The procedure is suitable for patients who do not have hindrances in their blood supply to the heart (nonischemic).

5. When to use CPT code 78453

CPT code 78453 should be used when a healthcare provider performs a single planar study of the heart to assess blood flow at rest or under stress. It is appropriate for patients who require evaluation of their cardiovascular system, particularly for identifying areas of deficient blood supply.

6. Documentation requirements

To support a claim for CPT 78453, the healthcare provider must document the following information:

• Patient’s medical history and reason for the procedure
• Details of the planar study, including whether it was performed at rest or under stress
• Specific findings and interpretations of the images
• Any additional quantification or measurements performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 78453, ensure that the procedure is performed according to the official description. It is important to follow the guidelines for documentation and accurately report the procedure. Additionally, be aware of any specific payer policies or requirements for reporting CPT 78453.

8. Historical information

CPT 78453 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a single planar study of the heart at rest to assess blood flow and identify areas of deficient supply.
2. A healthcare provider performs a planar study under stress by having the patient exercise on a treadmill to evaluate blood flow in the cardiovascular system.
3. A patient receives a single planar study of the heart after the administration of a vasodilator to assess blood flow during pharmacologic stress.
4. A healthcare provider performs a planar study to determine the ejection fraction and wall motion of the heart in a patient with suspected cardiac abnormalities.
5. A patient undergoes a single planar study to assess blood flow in the heart and identify areas of ischemia.
6. A healthcare provider performs a planar study to evaluate the effectiveness of a patient’s current treatment plan for cardiovascular disease.
7. A patient receives a single planar study to assess blood flow in the heart after experiencing symptoms of chest pain and shortness of breath.
8. A healthcare provider performs a planar study to monitor the progression of a patient’s cardiovascular disease and assess the need for further intervention.
9. A patient undergoes a single planar study to assess the impact of lifestyle changes on blood flow in the cardiovascular system.
10. A healthcare provider performs a planar study to evaluate the effectiveness of medication in improving blood flow in a patient with cardiovascular disease.