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2025 CPT code 78494

Cardiac blood pool imaging using gated equilibrium SPECT, performed at rest to assess wall motion and ejection fraction, with or without quantitative processing.

This code can be reported in addition to stress testing codes (93015-93018) if performed during exercise or pharmacologic stress. Do not report 78494 in conjunction with 78800, 78801, 78802, 78803, 78804, 78830, 78831, 78832, 78835. Modifier 26 should be appended for professional component only, and TC for technical component only (payer policies may vary for TC modifier use in hospitals).

Modifiers 26 (Professional Component) and TC (Technical Component) may be applicable. Modifier 59 may be appended to indicate a distinct procedural service. Other modifiers may also apply based on individual circumstances.

In simple words: This nuclear imaging test uses a special type of scan called SPECT to create a moving picture of your heart. It shows how well your heart pumps blood when you are resting. A small amount of radioactive material is injected into your vein, and a special camera takes pictures of the heart as it beats. This helps doctors see if your heart is working correctly.

Single-photon emission computed tomography (SPECT) is used to evaluate the heart's blood-pumping ability at rest. This gated equilibrium technique involves injecting a radioactive tracer, which emits gamma radiation detected by rotating cameras. The resulting 2D images are combined to create a 3D image, allowing for assessment of heart wall motion and ejection fraction. This helps evaluate how well the heart contracts and pumps blood to the body.

Example 1: A patient with a history of heart failure presents with shortness of breath. A resting gated equilibrium SPECT is performed to assess the heart's ejection fraction and wall motion., A patient undergoing chemotherapy requires monitoring of left ventricular function. A resting cardiac blood pool imaging study (78494) is ordered to assess for cardiotoxicity., A patient with suspected coronary artery disease undergoes a pharmacologic stress test. A resting gated equilibrium SPECT is performed to assess left ventricular function before stress.

Documentation should include the indication for the study, the type of tracer used, the method of acquisition (gated equilibrium SPECT), and the interpretation of the wall motion and ejection fraction. Any quantitative processing performed should also be documented.

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