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The CPT® Code 78434 refers to the procedure known as Absolute Quantitation of Myocardial Blood Flow (AQMBF) using Positron Emission Tomography (PET). This advanced imaging technique is primarily utilized for the diagnosis and monitoring of coronary artery disease (CAD), including cases of multi-vessel CAD. It also plays a crucial role in evaluating the severity of microvascular disease, assessing endothelial dysfunction, and determining the effectiveness of treatment interventions. The procedure begins with the establishment of intravenous access, allowing for the administration of a radiotracer. The patient is then positioned within the PET scanner, where images of the myocardium are captured at rest. Following this, stress is induced either through physical exercise or the intravenous administration of a pharmacological agent that causes coronary vasodilation. This is followed by another injection of the tracer and subsequent imaging during the induced cardiac stress. The data obtained from the PET myocardial perfusion imaging is processed using specialized software dedicated to AQMBF analysis. This software analyzes the images and generates a polar map that illustrates the relative perfusion across the coronary arterial beds and myocardial tissue. The output includes numerical data reflecting blood flow in milliliters per gram per minute (mL/g/min) at both rest and stress conditions. The AQMBF results are then integrated with the overall PET perfusion imaging data to produce a comprehensive report. It is important to note that CPT® Code 78434 is reported separately in addition to the code for the primary procedure performed during the imaging session.
© Copyright 2025 Coding Ahead. All rights reserved.
The Absolute Quantitation of Myocardial Blood Flow (AQMBF) using Positron Emission Tomography (PET) is indicated for several clinical scenarios, particularly in the assessment of coronary artery disease (CAD). The following conditions warrant the use of this procedure:
The procedure for Absolute Quantitation of Myocardial Blood Flow (AQMBF) using Positron Emission Tomography (PET) involves several critical steps to ensure accurate imaging and analysis of myocardial perfusion.
After the completion of the Absolute Quantitation of Myocardial Blood Flow (AQMBF) procedure, patients may be monitored for any immediate reactions to the radiotracer or the pharmacological agent used during stress induction. It is essential to ensure that the patient is stable before discharge. The results of the AQMBF study, along with the PET perfusion imaging data, will be compiled into a detailed report, which will be reviewed by the referring physician. This report will provide critical insights into the patient's myocardial blood flow and overall cardiac function, guiding further management and treatment decisions. Patients may be advised to resume normal activities unless otherwise directed by their healthcare provider.
| Short Descr | AQMBF PET REST & RX STRESS | Medium Descr | AQMBF PET REST AND PHARMACOLOGIC STRESS | Long Descr | Absolute quantitation of myocardial blood flow (AQMBF), positron emission tomography (PET), rest and pharmacologic stress (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) | 1 - Diagnostic Tests for Radiology Services | 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. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 78431 | Resequenced Code MPFS Status: Carrier Priced APC S ASC Z2 Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan | 78492 | MPFS Status: Carrier Priced APC S ASC Z2 PUB 100 CPT Assistant Article Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | MC | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | GC | This service has been performed in part by a resident under the direction of a teaching physician | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GA | Waiver of liability statement issued as required by payer policy, individual case | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | GW | Service not related to the hospice patient's terminal condition | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | MA | Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition | MF | The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2020-01-01 | Added | Code added. |