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BETA v.3.0

2025 CPT code 78451

Myocardial perfusion imaging, tomographic (SPECT), single study, at rest or stress.

When performed with exercise and/or pharmacologic stress, the appropriate stress testing code from the 93015-93018 series may be reported in addition to 78451.

Modifiers 26 (professional component), TC (technical component), and 52 (reduced services) may be applicable.

Medical necessity is established by the patient's symptoms and clinical history, suggesting the possibility of coronary artery disease or other cardiac conditions affecting myocardial perfusion.

The physician administers a radiopharmaceutical, and images are acquired using SPECT technology. The physician then interprets the images to assess myocardial perfusion.

IMPORTANT:(Do not report 78451 in conjunction with 78800, 78801, 78802, 78803, 78804, 78830, 78831, 78832, 78835) (For absolute quantification of myocardial blood flow [AQMBF] with single-photon emission computed tomography [SPECT], use 0742T)

In simple words: This is a nuclear medicine scan that shows how well blood flows to the heart muscle, done during rest or exercise.

Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)

Example 1: A patient with chest pain undergoes a stress test with 78451 to evaluate for coronary artery disease., A patient who had a heart attack has 78451 performed at rest to assess the extent of myocardial damage., A patient with a history of coronary artery disease undergoes a rest and stress 78451 (using 78452) to evaluate the effectiveness of treatment.

Documentation should include the indication for the study, the type of stress (if performed), the radiopharmaceutical used, and the interpretation of the images.

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