How To Use CPT Code 78473

CPT 78473 describes the diagnostic procedure known as cardiac blood pool imaging, specifically focusing on the evaluation of wall motion and ejection fraction. This article will provide an overview of CPT code 78473, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 78473?

CPT 78473 is a diagnostic procedure used to assess cardiac function by performing cardiac blood pool imaging. This procedure involves evaluating wall motion and ejection fraction, which provides valuable information about how the heart is pumping blood throughout the body. It is typically performed at rest and during stress, either through exercise or pharmacologic stress.

2. Official Description

The official description of CPT code 78473 is: ‘Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification.’

3. Procedure

1. The procedure begins with the injection of a radionuclide into the patient’s bloodstream.
2. Images are then taken at different intervals during the cardiac cycle using a gamma camera.
3. The procedure involves performing the imaging study while the patient is at rest and again during stress, which can be induced through exercise or pharmacologic stress.
4. During the imaging study, the technician evaluates the wall motion and calculates the ejection fraction, which measures the percentage of blood pumped out of a filled ventricle with each heartbeat.
5. Additional quantification may be performed, depending on the specific circumstances and requirements of the study.

4. Qualifying circumstances

CPT code 78473 is typically used for patients who require an evaluation of their cardiac function. This procedure is commonly performed for individuals with suspected or known heart conditions, such as coronary artery disease or heart failure. It is important to note that this procedure should not be reported in conjunction with certain other codes, including 78451-78454, 78481, 78483, and 78494.

5. When to use CPT code 78473

CPT code 78473 should be used when performing cardiac blood pool imaging to evaluate wall motion and ejection fraction at rest and during stress. This code is appropriate when the procedure involves multiple studies and includes both rest and stress imaging. It is important to determine whether the test was performed at rest or during stress to accurately assign the correct code.

6. Documentation requirements

To support a claim for CPT code 78473, the documentation should include the following information:

• Indication for the procedure and the need for evaluating wall motion and ejection fraction
• Details of the imaging study, including whether it was performed at rest or during stress
• Specific quantification performed, if applicable
• Date and time of the procedure
• Results of the evaluation, including any abnormalities or significant findings
• Signature of the healthcare professional performing or supervising the procedure

7. Billing guidelines

When billing for CPT code 78473, it is important to ensure that the procedure meets the criteria outlined in the official description. Additionally, it should not be reported in conjunction with certain other codes, as mentioned earlier. It is crucial to review the specific guidelines provided by insurance carriers to ensure accurate and appropriate billing.

8. Historical information

CPT code 78473 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes cardiac blood pool imaging at rest and during exercise stress to evaluate wall motion and ejection fraction.
2. During a pharmacologic stress test, a patient undergoes cardiac blood pool imaging to assess wall motion and ejection fraction.
3. A patient with known heart failure undergoes cardiac blood pool imaging at rest and during exercise stress to monitor changes in wall motion and ejection fraction.
4. As part of a comprehensive cardiac evaluation, a patient undergoes cardiac blood pool imaging at rest and during pharmacologic stress to assess wall motion and ejection fraction.
5. A patient with suspected coronary artery disease undergoes cardiac blood pool imaging at rest and during exercise stress to evaluate wall motion and ejection fraction.
6. During a follow-up appointment, a patient undergoes cardiac blood pool imaging at rest and during pharmacologic stress to assess changes in wall motion and ejection fraction.
7. A patient with a history of heart disease undergoes cardiac blood pool imaging at rest and during exercise stress to evaluate wall motion and ejection fraction.
8. As part of a preoperative assessment, a patient undergoes cardiac blood pool imaging at rest and during pharmacologic stress to assess wall motion and ejection fraction.
9. A patient with symptoms of heart failure undergoes cardiac blood pool imaging at rest and during exercise stress to evaluate wall motion and ejection fraction.
10. During a routine cardiac evaluation, a patient undergoes cardiac blood pool imaging at rest and during pharmacologic stress to assess changes in wall motion and ejection fraction.