2025 CPT code 78473
(Active) Effective Date: N/A Radiology - Nuclear Medicine Feed
Gated equilibrium cardiac blood pool imaging, multiple studies performed at rest and stress (exercise or pharmacologic), including wall motion and ejection fraction.
Modifiers, such as 26 (professional component), 52 (reduced services), 53 (discontinued procedure), and others, can be applied to 78473 when appropriate.
Medical necessity for this procedure must be established based on the patient's symptoms, medical history, and other diagnostic tests. The documentation should clearly justify the need for this specific test to evaluate the patient's cardiac condition.
A physician specializing in nuclear medicine or cardiology is responsible for supervising and interpreting this procedure. Before imaging, a radioactive tracer is injected into the patient's bloodstream. The gamma camera captures images at different stages of the cardiac cycle, both during rest and induced stress.
In simple words: This is a nuclear medicine test that creates images of your heart's chambers to evaluate how well your heart pumps blood. It's done both at rest and during stress (induced by exercise or medication), and it measures how much blood is pumped out with each beat (ejection fraction). This helps doctors diagnose heart conditions.
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. (Do not report 78472, 78473 in conjunction with 78451-78454, 78481, 78483, 78494)
Example 1: A patient with suspected coronary artery disease undergoes this test to evaluate the heart's pumping function during rest and stress. The results help determine the presence and extent of blockages., A patient with a history of heart attack has this scan to assess the damage to the heart muscle and determine the ejection fraction. This information guides treatment decisions., A patient before and after heart surgery or other interventions has this scan to monitor the effectiveness of the treatment and assess changes in heart function.
The documentation must include the medical necessity for the procedure, the type of stress used (exercise or pharmacologic), the patient's response to stress, and the interpretation of the images, including the ejection fraction and wall motion assessment.