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Cardiac blood pool imaging, gated equilibrium, is a diagnostic procedure that utilizes single photon emission computed tomography (SPECT) to evaluate the heart's ability to pump blood effectively. This imaging technique involves the use of a radiolabeled isotope tracer, which is injected into the patient's bloodstream to visualize the heart's function. SPECT employs one or more gamma cameras that capture the emitted gamma radiation from the tracer, allowing for the creation of detailed three-dimensional images of the heart. During the procedure, the patient is positioned on an imaging table, and cardiac electrodes are placed to monitor the heart's electrical activity through continuous electrocardiogram (ECG) tracing. The gamma camera(s) are strategically positioned over the chest to ensure optimal imaging. An intravenous line is established for the administration of the radiolabeled tracer, which circulates through the heart and blood vessels. Following the injection, scanning occurs at predetermined intervals, during which the emitted radioactive energy is transformed into images that can be analyzed on a computer. This process enables the physician to assess the motion of the heart walls and determine the heart's pumping efficiency. Additionally, the ejection fraction, a critical measurement indicating the percentage of blood ejected from the heart with each contraction, is calculated using a gated equilibrium technique. This technique synchronizes image capture with the heart's electrical signals, resulting in high-resolution images that provide valuable insights into cardiac function. The physician interprets the images, calculates the ejection fraction, and may quantify other functional parameters based on the distribution of the radionuclide, culminating in a comprehensive written report of the findings.
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The cardiac blood pool imaging procedure is indicated for various clinical scenarios where assessment of heart function is necessary. The following conditions may warrant this imaging study:
The cardiac blood pool imaging procedure involves several key steps to ensure accurate assessment of heart function:
After the cardiac blood pool imaging procedure, patients are typically monitored for a short period to ensure there are no immediate adverse reactions to the tracer. There are generally no specific restrictions following the procedure, and patients can resume normal activities unless otherwise advised by their physician. The results of the imaging study are usually discussed in a follow-up appointment, where the physician will interpret the findings and recommend any necessary further evaluations or treatments based on the results.
| Short Descr | HEART IMAGE SPECT | Medium Descr | CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT | Long Descr | Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing | 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. | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | 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). | 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. | 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.) | 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 | 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 | 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 | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | 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. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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