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2025 CPT code 78452

Multiple myocardial perfusion imaging studies using SPECT, including attenuation correction, wall motion analysis, and ejection fraction calculation, at rest and/or during stress.

Adhere to CPT guidelines and payer-specific requirements for documentation and coding.

Modifiers 26 (professional component), TC (technical component), and others may apply depending on the circumstances of the service provided and payer rules.

Medical necessity is established by the presence of symptoms, risk factors, or prior history suggestive of coronary artery disease or myocardial ischemia requiring further evaluation to guide treatment and management.

The clinical responsibility includes performing the nuclear medicine study, administering the radionuclide, interpreting the images, and generating a report.

IMPORTANT:78451 (single study), 78472 (PET myocardial perfusion imaging)

In simple words: This test uses a special camera and a small amount of radioactive material to take multiple pictures of your heart at rest and while it's working hard (either through exercise or medication). These pictures help doctors see how well blood flows through your heart.

This CPT code encompasses multiple tomographic myocardial perfusion imaging (SPECT) studies of the heart, performed at rest and/or under stress (exercise or pharmacologic). The procedure includes attenuation correction, qualitative or quantitative assessment of wall motion, ejection fraction determination (by first-pass or gated technique), and additional quantification when performed.It involves multiple injections of radionuclide and image acquisition at different phases (rest, stress, redistribution, and rest reinjection, if applicable).

Example 1: A 65-year-old male patient presents with chest pain.A stress test and multiple SPECT studies (code 78452) are performed to evaluate myocardial perfusion and rule out coronary artery disease., A 50-year-old female patient with known coronary artery disease undergoes a pharmacologic stress test with multiple SPECT scans (code 78452) to assess the effectiveness of her medication regimen and monitor disease progression., A 70-year-old patient with a history of heart failure is scheduled for a resting and redistribution SPECT study (code 78452) to evaluate myocardial viability and guide treatment decisions.

* Patient demographics and medical history.* Indication for the study (e.g., chest pain, known CAD).* Type of stress test (exercise or pharmacologic) with details on the procedure and patient tolerance.* Radiopharmaceutical used and administration details.* Image acquisition parameters.* Qualitative and quantitative analysis of the images, including wall motion assessment and ejection fraction.* Physician's interpretation and report.

** For absolute quantification of myocardial blood flow (AQMBF) with SPECT, use code 0742T.

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