The matrix below contains all of the imaging and cardiac procedure codes NIA will authorize on behalf Note: Cardiac CPT codes requiring prior authorization for Commercial members are denoted by footnote 78451, 78452, 78453, 78454

CPT CODE 78452 - Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection

78453. 15155. L2340. 93998.

MYOCARDIAL SPECT MULTIPLE STUDIES NM. 78227. HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ NM 78453 MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/ NM. 78230 . SALIVARY GLND IMG 78454NM Radiology Prior Authorization CPT® Code List - UnitedHealthcare Medicare Advantage Subject: providers should code and bill only two units as coding rules allow providers to round up to the nearest full HCPCS code description. CPT/HCPCS Number Code of Units Description 78452 1 MPI, SPECT, multiple A9500 2 99mTc sestamibi per study dose 93015* 1 Cardiovascular stress test, w interpretation and report J0152 2 Adenosine per 30 mg Difference Between CPT code 78451 and 78452 For CPT code 78451, a single study is performed either at rest or stress. For non-stress exam, a radionuclide is injected and heart images are obtained without any stress induction. For stress exam, stress is induced with standard treadmill exercise test.

2018-02-12

74150 78452. Tomographic (SPECT); multiple studies, at rest and/or. 21 Dec 2009 Several CPT and HCPCS codes were deleted and replaced with new codes for 78452.

Head with contrast- 70460. Thoracic spine with and without contrast- 72157. Cardiolite- 78452. Head without contrast- 70450. Lumbar spine with contrast-

All coronary (SPECT), single study, at rest or stress. 78452. Myocardial perfusion imaging, tomographic. Testing Procedure (from American Society of Nuclear Cardiology, 2009).

0343 CPT® Code 78451 in section: Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed) Myocardial Infarct Imaging - CPT codes 78466-78469. A9538 Technetium Tc-99m pyrophosphate, diagnostic, per study dose up to 25 mCi's is used for these procedures. This code is used for Pyrophosphate (PYP) compounded /prepared with technetium Tc99m pertechnetate. It is prepared external to the patient and is then administered Use the appropriate CPT code, 78451 – 78496, to describe the primary service performed, including whether it is a single study or multiple studies. B. An ICD-9-CM code supporting the medical necessity for the service must be submitted with each claim. C. Only one professional component (26) may be billed for the primary service performed. 2020 Cpt Code for Entyvio.
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78452. MYOCARDIAL SPECT MULTIPLE STUDIES NM. 78227. HEPATOBIL SYST IMAG INC GB W/PHARMA Radiology Prior Authorization CPT® Code List - UnitedHealthcare Medicare Intravenous Radiopharmaceutical Therapy (CPT Code 79101) Radiopharmaceutical therapy, by intravenous administration (CPT code 79101) is not reimbursable when billed with CPT codes 36400 36410, 79403, 90760, 90765 thru 90768, 90780, 96360, 96374, 96375, 96408 and 96409. Diagnostic Radiopharmaceutical Agents This web page is an entry point to find 78452 ICD-9 code mapping to ICD-10.

Prior authorization numbers represent the specific procedure requested and are valid for 45 calendar days from the date they’re issued. CPT®* Codes Included in AIM Preauthorization Program for 2013 With Grouper Numbers Computerized Tomography (CT) CPT Description Abdomen 74150 CT abdomen; w/o contrast 78452 multiple studies at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest CPT: Visibility: Summary Only: Description: CPT is a list of descriptive terms and identifying numeric codes for medical services and procedures that are provided by physicians and health care professionals.
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Cardiac Stress Test (4 CPT codes required) 78452 multi study PET (POSITRON EMISSION TOMOGRAPHY) Cardiac Blood Pool Imaging, Gated Equil, Single Study Rest, w/ Rt Vent Eject (2nd MUGA Code) 73725 x 2 74185 76377 x 3

providers should code and bill only two units as coding rules allow providers to round up to the nearest full HCPCS code description. CPT/HCPCS Number Code of Units Description 78452 1 MPI, SPECT, multiple A9500 2 99mTc sestamibi per study dose 93015* 1 Cardiovascular stress test, w interpretation and report J0152 2 Adenosine per 30 mg Find National Coverage Documents (NCD, NCA, CAL, MEDCAC, TA, MCD, CPI) and Local Coverage Documents (Articles and Policies (LCD)) by providing criteria (e.g. Document Id, Geographic Area, Keywords, CPT/HCPCS codes, NCA/CAL Status, Benefit Category, Date Criteria, and ICD-9 codes). The following codes are included below for informational purposes only and are subject to change without notice. Inclusion or exclusion of a code does not constitute or imply subscriber coverage or provider reimbursement.