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Cardiac blood pool imaging, as described by CPT® Code 78473, is a diagnostic procedure that utilizes scintigraphy along with a radiolabeled isotope tracer to evaluate the heart's efficiency in pumping blood. This imaging technique is essential for assessing various aspects of cardiac function, including the motion of the heart walls, the size and shape of the heart chambers, and the overall ventricular systolic and diastolic function, as well as the ejection fraction. The procedure is designed to provide a comprehensive analysis by comparing the heart's performance at rest and during stress, which can be induced through exercise or pharmacological means. This dual assessment allows for the acquisition of quantitative data within a single study, enhancing the diagnostic capabilities of healthcare providers. During the procedure, the patient is positioned on an imaging table, and cardiac electrodes are placed to facilitate continuous electrocardiogram (ECG) monitoring. A gamma camera is then positioned over the patient's chest, interfacing with the ECG to synchronize the imaging process. An intravenous line is established for the injection of the radiolabeled isotope tracer, which circulates through the bloodstream. The gamma camera captures the radioactive energy emitted from the tracer, converting it into detailed images of the heart and surrounding great vessels. Typically, planar views are obtained from multiple angles to ensure a thorough evaluation of different cardiac regions. In a gated equilibrium study, images are specifically recorded at designated phases of the cardiac cycle, such as during diastole, as dictated by the ECG waveforms. For the stress component of the study, the patient may engage in physical activity on a treadmill or exercise bicycle, or alternatively, receive a pharmacological agent to simulate the effects of exercise on the heart. Following the imaging, the physician analyzes the captured images, calculates the ejection fraction, and may quantify additional parameters related to heart function based on the distribution of the radionuclide. A comprehensive written report detailing the findings is then generated by the physician. It is important to note that CPT® Code 78472 is designated for a single planar study conducted either at rest or under stress, while CPT® Code 78473 is specifically utilized when multiple studies are performed at both rest and stress.
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The cardiac blood pool imaging procedure, as defined by CPT® Code 78473, is indicated for various clinical scenarios where detailed assessment of cardiac function is necessary. The following conditions may warrant this imaging study:
The cardiac blood pool imaging procedure involves several key steps to ensure accurate and comprehensive evaluation of cardiac function. The following procedural steps are performed:
Post-procedure care for patients undergoing cardiac blood pool imaging typically involves monitoring for any immediate reactions to the radiolabeled isotope tracer. Patients are generally advised to hydrate adequately to facilitate the elimination of the tracer from their system. The physician will review the imaging results and provide a comprehensive report detailing the findings, which may include recommendations for further evaluation or treatment based on the results. Patients may be informed about any follow-up appointments necessary to discuss the results and any potential implications for their cardiac health.
| Short Descr | GATED HEART MULTIPLE | Medium Descr | CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT | Long Descr | Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional 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. | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | 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 | 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 |
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| 2011-01-01 | Changed | Short description changed. |
| 1992-01-01 | Added | First appearance in code book in 1992. |
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