How To Use CPT Code 78472

CPT 78472 describes the diagnostic procedure known as cardiac blood pool imaging with gated equilibrium. 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 78472?

CPT 78472 is a diagnostic procedure used to perform cardiac blood pool imaging with gated equilibrium. This procedure involves the use of a radionuclide injected into the bloodstream to capture images of the heart’s function and the flow of blood through it. The images are taken at different intervals during the cardiac cycle using a gamma camera. This procedure can be performed with the patient at rest or with exercise or pharmacologic stress.

2. Official Description

The official description of CPT code 78472 is: ‘Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing.’

3. Procedure

1. The procedure begins with the injection of a radionuclide into the patient’s bloodstream.
2. Images are then taken through a gamma camera at different intervals during the cardiac cycle.
3. The procedure can be performed while the patient is at rest or with exercise or pharmacologic stress.
4. A wall motion study and ejection fraction are measured during the procedure.
5. Additional quantitative processing may be performed if necessary.

4. Qualifying circumstances

CPT 78472 is performed on patients who require diagnostic imaging of the cardiovascular system. This procedure is used to assess the heart’s function and the flow of blood through it. It is typically performed on patients with suspected cardiac abnormalities or those who require further evaluation of their cardiac health. The procedure can be performed on patients at rest or with exercise or pharmacologic stress.

5. When to use CPT code 78472

CPT code 78472 should be used when performing a single study of cardiac blood pool imaging with gated equilibrium at rest or stress. This code should be used when the procedure includes a wall motion study and ejection fraction measurement. If the procedure includes additional quantitative processing, it should also be reported with this code.

6. Documentation requirements

To support a claim for CPT code 78472, the following documentation is required:

• Indication for the procedure
• Date of the procedure
• Whether the procedure was performed at rest or with exercise or pharmacologic stress
• Results of the wall motion study and ejection fraction measurement
• Any additional quantitative processing performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 78472, ensure that the procedure meets the criteria outlined in the official description. This includes performing a single study at rest or stress, with a wall motion study and ejection fraction measurement. If additional quantitative processing is performed, it should also be reported with this code. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT code 78472 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes cardiac blood pool imaging with gated equilibrium at rest to assess their heart’s function and blood flow.
2. A patient undergoes cardiac blood pool imaging with gated equilibrium with exercise stress to evaluate their cardiac health during physical activity.
3. A patient undergoes cardiac blood pool imaging with gated equilibrium with pharmacologic stress to assess their heart’s function under simulated exercise conditions.
4. A patient undergoes cardiac blood pool imaging with gated equilibrium at rest, and additional quantitative processing is performed to further analyze the results.
5. A patient undergoes cardiac blood pool imaging with gated equilibrium with exercise stress, and a wall motion study and ejection fraction measurement are performed to evaluate their cardiac function during physical activity.
6. A patient undergoes cardiac blood pool imaging with gated equilibrium with pharmacologic stress, and additional quantitative processing is performed to analyze the results under simulated exercise conditions.
7. A patient undergoes cardiac blood pool imaging with gated equilibrium at rest, and the procedure includes a wall motion study and ejection fraction measurement to assess their heart’s function.
8. A patient undergoes cardiac blood pool imaging with gated equilibrium with exercise stress, and the procedure includes additional quantitative processing to further analyze the results during physical activity.
9. A patient undergoes cardiac blood pool imaging with gated equilibrium with pharmacologic stress, and the procedure includes a wall motion study and ejection fraction measurement to evaluate their cardiac function under simulated exercise conditions.
10. A patient undergoes cardiac blood pool imaging with gated equilibrium at rest, and the procedure includes a wall motion study, ejection fraction measurement, and additional quantitative processing to comprehensively assess their heart’s function.