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2025 CPT code 78432

Myocardial imaging using PET scan, combining perfusion and metabolic evaluation with dual radiotracers.

Follow CPT coding guidelines for nuclear medicine procedures, including guidelines for reporting multiple studies, concurrent CT scans, professional vs. technical components, and appropriate use of modifiers. Payer-specific coding guidelines must be consulted.

Modifiers 26 (professional component) and TC (technical component) can be applied as appropriate depending on the services performed.Other modifiers may be used depending on the specific circumstances of the case.

Medical necessity for a 78432 study is typically established based on the presence of symptoms suggestive of coronary artery disease, prior myocardial infarction, known or suspected cardiac dysfunction, or pre-operative assessment for surgical intervention.Documentation of symptoms, risk factors, and clinical findings must support the need for the procedure.Payer-specific guidelines may apply.

A cardiologist or nuclear medicine physician is typically responsible for performing and interpreting this study. The clinical responsibilities encompass patient selection, administration of radiotracers, acquisition of PET images, image analysis, and report generation.In some cases, collaboration with other specialists may be necessary for comprehensive patient care.

IMPORTANT:Related codes include 78429, 78430, 78431, 78433, 78459, 78491, and 78492, each representing variations in the type of study (perfusion only, metabolic only, combined), number of studies (single vs. multiple), and use of concurrent CT scans.Modifiers 26 (professional component) and TC (technical component) may be appended as appropriate.

In simple words: A PET scan of the heart using two special dyes to show how well the heart muscle is working and how much blood it's receiving. This test gives detailed information about the heart's health.

This CPT code encompasses a myocardial imaging procedure utilizing positron emission tomography (PET) technology.The study involves a combined perfusion and metabolic evaluation of the heart muscle, employing two different radiotracers.The procedure assesses myocardial perfusion (blood flow), metabolic function (e.g., glucose uptake, fatty acid metabolism), and, if performed, ventricular wall motion and ejection fraction.The dual-tracer approach enhances the diagnostic capabilities by providing comprehensive information about myocardial viability.

Example 1: A 65-year-old male presents with chest pain and suspected coronary artery disease. A 78432 study is performed to assess myocardial perfusion and viability, aiding in diagnosis and treatment planning., A 70-year-old female post-myocardial infarction undergoes a 78432 study to evaluate the extent of myocardial damage and assess the effectiveness of revascularization procedures., A 50-year-old male with diabetes and risk factors for heart disease undergoes a 78432 study to assess myocardial viability before cardiac surgery.

Patient demographics, clinical history, indication for study, radiotracer used, images acquired (with quality assurance), quantitative data (perfusion and metabolic parameters), interpretation report, and any significant findings.Documentation should also include consent forms and billing information.

** Accurate coding requires careful review of the specific procedure performed, including the radiotracers used, the number of studies (rest and/or stress), and the acquisition of any concurrent CT scans.Always consult the most recent CPT manual and payer-specific guidelines for proper billing practices.

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