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Myocardial contrast perfusion echocardiography (MCPE) is a specialized imaging procedure designed to evaluate the micro-perfusion of the heart muscle, either at rest or during stress conditions. This technique utilizes an intravenous infusion of microbubbles, which are tiny gas-filled spheres that mimic the behavior of red blood cells, allowing for enhanced visualization of blood flow within the myocardium. The microbubbles are composed of a hemodynamically inert gas core encased in a stabilizing outer shell, enabling them to traverse the pulmonary capillaries and enter systemic circulation. When subjected to high-intensity ultrasound (US), these microbubbles oscillate and can be destroyed, providing critical information about myocardial blood flow. MCPE is particularly useful in assessing myocardial ischemia, which occurs when there is insufficient blood flow to the heart muscle, and in evaluating myocardial viability, which refers to the heart muscle's ability to function after an ischemic event. The procedure can be performed in patients with acute myocardial infarction (AMI) to identify areas of heart muscle damage and to assess the effectiveness of therapeutic interventions. Additionally, MCPE can help delineate the extent of collateral perfusion and viable myocardium, which is essential for determining the prognosis and treatment strategies for patients with coronary artery disease (CAD). During the procedure, the patient is positioned supine on an examination table, and an intravenous line is established to facilitate the infusion of the microbubble solution. The ultrasound transducer is then placed on the chest to capture baseline images of myocardial function. Following the infusion of microbubbles, advanced imaging techniques and software are employed to measure parameters such as blood volume fraction and flow velocity, which are critical for determining myocardial blood flow. If indicated, stress testing may be conducted using a coronary vasodilator like dobutamine or through physical exertion on a reclining bicycle, allowing for a comprehensive comparison of myocardial function at rest and under stress conditions.
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Myocardial contrast perfusion echocardiography (MCPE) is indicated for the following conditions:
The procedure for myocardial contrast perfusion echocardiography (MCPE) involves several key steps that ensure accurate assessment of myocardial blood flow:
Following the myocardial contrast perfusion echocardiography (MCPE), patients may be monitored for any immediate reactions to the microbubble infusion. It is important to assess the patient's overall condition and ensure that they are stable before discharge. The results of the MCPE will be analyzed and interpreted by a qualified healthcare professional, who will provide insights into myocardial ischemia and viability based on the imaging findings. Any necessary follow-up appointments or additional testing will be discussed with the patient to ensure comprehensive care and management of their cardiac health.
| Short Descr | MYOCRD CONTRAST PRFUJ ECHO | Medium Descr | MYOCARDIAL PERFUSION ECHO ISCHM/VIABILITY ASSMT | Long Descr | Myocardial contrast perfusion echocardiography, at rest or with stress, for assessment of myocardial ischemia or viability (List separately in addition to code for primary procedure) | Status Code | Carriers Price the Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 93306 | MPFS Status: Active Code APC S CPT Assistant Article Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography | 93307 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography | 93308 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study | 93350 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; | 93351 | MPFS Status: Active Code APC S CPT Assistant Article Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional |
| GZ | Item or service expected to be denied as not reasonable and necessary | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition |
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| 2017-01-01 | Added | First appearance in codebook. |
| 2017-01-01 | Changed | Code description changed. |
| 2016-07-01 | Added | Code added. |
| 2016-01-01 | Added | Code Added |
| 2016-01-01 | Changed | Change in AMA Guidelines |
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