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Myocardial imaging, specifically using the CPT® Code 78469, refers to a diagnostic procedure that employs three-dimensional single positron emission computed tomography (SPECT) in conjunction with a radiolabeled isotope tracer. This imaging technique is primarily utilized to identify and document areas of cardiac muscle that have experienced scarring or infarction, as well as to assess the function of the coronary arteries. The procedure allows for a visual comparison of the heart muscle under stress conditions against delayed images taken at rest, which can yield additional quantitative insights regarding viable myocardium and the overall prognosis for the patient. The advanced technology of a rotating camera system, combined with tomographic reconstruction capabilities, enables the detection of inferior and posterior cardiac abnormalities, including small infarct areas and the blood vessels that supply these regions. During the procedure, the patient is carefully positioned on an imaging table, and one or more gamma cameras are strategically placed over the chest area. An intravenous line is established to facilitate the injection of the radiolabeled isotope tracer directly into the patient's circulatory system. As the camera(s) rotate around the body, they capture detailed images of the myocardium by detecting the radioactive energy emitted from the tracer. These images are subsequently processed and downloaded to a computer, where they can be viewed in tomographic sections or as a cinematic display. Finally, the physician interprets the results of the study and compiles a comprehensive written report detailing the findings.
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The myocardial imaging procedure coded as CPT® 78469 is indicated for various clinical scenarios where assessment of cardiac muscle and coronary artery function is necessary. The following conditions may warrant this imaging technique:
The myocardial imaging procedure using CPT® 78469 involves several critical steps to ensure accurate imaging and assessment of the heart. The following procedural steps are performed:
After the myocardial imaging procedure coded as CPT® 78469, patients may be monitored for a short period to ensure there are no immediate adverse reactions to the radiolabeled isotope tracer. It is important for patients to follow any specific post-procedure instructions provided by the healthcare team, which may include hydration recommendations to help flush the tracer from the body. Patients can typically resume normal activities shortly after the procedure, but they should be advised to report any unusual symptoms or concerns to their healthcare provider. The physician will review the imaging results and discuss the findings with the patient during a follow-up appointment, where further management or treatment options may be considered based on the results of the study.
| Short Descr | HEART INFARCT IMAGE (3D) | Medium Descr | MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ | Long Descr | Myocardial imaging, infarct avid, planar; tomographic SPECT with or without quantification | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services 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 | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I1E - Standard imaging - nuclear medicine | MUE | 1 | CCS Clinical Classification | 209 - Radioisotope scan and function studies |
| 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. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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. | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | 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 | 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 | 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 |
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| Pre-1990 | Added | Code added. |
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