How To Use CPT Code 78466

CPT 78466 describes the planar nuclear imaging of heart muscle after the injection of a radioactive substance that accumulates in the area of damaged myocardium. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78466?

CPT 78466 can be used to describe the planar nuclear imaging of heart muscle to identify and locate the damage caused by a recent myocardial infarction (MI). This code is used when a provider performs this imaging procedure using a radioactive substance that accumulates in the area of damaged myocardium.

2. Official Description

The official description of CPT code 78466 is: ‘Myocardial imaging, infarct avid, planar; qualitative or quantitative.’

3. Procedure

1. The provider administers a radioactive tracer into the patient’s vein.
2. The radioactive tracer travels towards the heart muscle.
3. A gamma camera detects the gamma radiations emitted by the radioactive tracer.
4. The gamma camera produces two-dimensional images of the radioactive substance throughout the heart muscle.
5. The provider analyzes these images to determine the location and extent of infarct in the heart muscle.

4. Qualifying circumstances

CPT 78466 is used when a patient has recently experienced a myocardial infarction (MI) and the provider needs to assess the location and extent of the damage in the heart muscle. The procedure involves the use of a radioactive tracer that accumulates in the area of damaged myocardium. It is important to note that this code is specific to planar imaging and can be used for both qualitative and quantitative assessments.

5. When to use CPT code 78466

CPT code 78466 should be used when a provider performs planar nuclear imaging of heart muscle to assess the damage caused by a recent myocardial infarction. This code is appropriate for both qualitative and quantitative assessments. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 78466, the provider must document the following information:

• Indication for the procedure, such as recent myocardial infarction
• Type of radioactive tracer used
• Date and time of the procedure
• Images obtained and their interpretation
• Location and extent of infarct in the heart muscle
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 78466, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately report the type of imaging performed (qualitative or quantitative) and any additional services provided. If reporting only the physician’s interpretation, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, be aware of payer policies regarding modifier TC for hospitals. If the provider renders both the professional and technical components, do not append any modifiers to the radiology code.

8. Historical information

CPT 78466 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient who recently had a myocardial infarction undergoes planar nuclear imaging to assess the extent of damage in the heart muscle.
2. A provider performs planar nuclear imaging on a patient who experienced chest pain and other symptoms suggestive of a myocardial infarction.
3. A patient with a history of myocardial infarction undergoes planar nuclear imaging to monitor the progression of the damage in the heart muscle.
4. A provider performs planar nuclear imaging on a patient with risk factors for myocardial infarction to assess the presence of any damage in the heart muscle.
5. A patient who recently underwent a coronary intervention undergoes planar nuclear imaging to evaluate the success of the procedure and assess any damage in the heart muscle.
6. A provider performs planar nuclear imaging on a patient with suspected myocardial infarction to confirm the diagnosis and determine the extent of damage in the heart muscle.
7. A patient with a history of myocardial infarction undergoes planar nuclear imaging as part of a follow-up evaluation to assess the healing process in the heart muscle.
8. A provider performs planar nuclear imaging on a patient with symptoms suggestive of a myocardial infarction to rule out any damage in the heart muscle.
9. A patient with a history of myocardial infarction undergoes planar nuclear imaging to assess the effectiveness of their current treatment regimen in preventing further damage in the heart muscle.
10. A provider performs planar nuclear imaging on a patient with risk factors for myocardial infarction to screen for any early signs of damage in the heart muscle.