How To Use CPT Code 78496

CPT 78496 describes the procedure for cardiac blood pool imaging using a first-pass technique to assess the right ventricular ejection fraction. 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 78496?

CPT 78496 can be used to describe the procedure for cardiac blood pool imaging using a first-pass technique to assess the right ventricular ejection fraction. This code is used when the provider performs a separate procedure in conjunction with a primary procedure to evaluate how the heart is pumping blood to the rest of the body.

2. Official Description

The official description of CPT code 78496 is: ‘Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (List separately in addition to code for primary procedure).’ This code is reported in conjunction with a primary procedure and provides additional information on the right ventricular ejection fraction.

3. Procedure

1. The procedure begins with the injection of a radionuclide into the bloodstream.
2. Two injections are given, one that adheres to red blood cells and another that contains a radionuclide.
3. Images are taken through a gamma camera at different intervals during the cardiac cycle.
4. The procedure is performed while the patient is at rest.

4. Qualifying circumstances

CPT 78496 is performed on patients who require evaluation of the right ventricular ejection fraction using a first-pass technique. This procedure is typically performed in conjunction with a primary procedure and provides additional information on cardiac function.

5. When to use CPT code 78496

CPT code 78496 should be used when the provider performs cardiac blood pool imaging using a first-pass technique to assess the right ventricular ejection fraction. This code is reported in addition to the code for the primary procedure.

6. Documentation requirements

To support a claim for CPT 78496, the provider must document the following information:

• Indication for the procedure
• Details of the primary procedure
• Date and time of the procedure
• Specific technique used for cardiac blood pool imaging
• Results of the evaluation of the right ventricular ejection fraction
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 78496, ensure that the procedure is performed in conjunction with a primary procedure. This code should be reported separately to provide additional information on the right ventricular ejection fraction. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 78496 was added to the Current Procedural Terminology system on January 1, 1999. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes cardiac blood pool imaging using a first-pass technique to assess the right ventricular ejection fraction during a rest study.
2. Cardiac blood pool imaging is performed using a first-pass technique to evaluate the right ventricular ejection fraction in a patient undergoing a stress test.
3. A provider performs cardiac blood pool imaging with a first-pass technique to assess the right ventricular ejection fraction in a patient with suspected heart failure.
4. During a cardiac catheterization procedure, the provider also performs cardiac blood pool imaging using a first-pass technique to evaluate the right ventricular ejection fraction.
5. A patient with a history of cardiac disease undergoes cardiac blood pool imaging with a first-pass technique to assess the right ventricular ejection fraction as part of their routine follow-up.
6. Cardiac blood pool imaging is performed using a first-pass technique to evaluate the right ventricular ejection fraction in a patient with suspected arrhythmia.
7. A provider performs cardiac blood pool imaging with a first-pass technique to assess the right ventricular ejection fraction in a patient with known congenital heart disease.
8. During a cardiac stress test, the provider also performs cardiac blood pool imaging using a first-pass technique to evaluate the right ventricular ejection fraction.
9. A patient with a recent heart attack undergoes cardiac blood pool imaging with a first-pass technique to assess the right ventricular ejection fraction as part of their post-treatment evaluation.
10. Cardiac blood pool imaging is performed using a first-pass technique to evaluate the right ventricular ejection fraction in a patient with suspected valvular heart disease.