2025 CPT code 78472
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Imaging - Nuclear Medicine Procedures Radiology Feed
Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress, wall motion study plus ejection fraction.
Modifiers may apply depending on the circumstances of service delivery (e.g., 26 for professional component, 59 for distinct procedural service, TC for technical component, etc.).
Medical necessity for this procedure is established based on the patient's clinical presentation, such as chest pain, shortness of breath, or known cardiovascular disease.It helps assess cardiac function, identify areas of myocardial ischemia or infarction, and guide treatment decisions.
The clinical responsibility involves administering a radionuclide, acquiring images using a gamma camera at various points during the cardiac cycle, and interpreting the results to assess cardiac function, wall motion, and ejection fraction.
In simple words: This test uses imaging to check how well your heart is pumping blood.It involves a single scan, either while you are resting or while exercising or receiving medication to stimulate your heart.
This CPT code represents a gated equilibrium cardiac blood pool imaging study using a planar technique.The imaging is performed as a single study, either at rest or under stress conditions (exercise or pharmacologic). The procedure includes analysis of wall motion and ejection fraction, with optional additional quantitative processing.For assessment of right ventricular ejection fraction using a first-pass technique, code 78496 should be used in addition.
Example 1: A patient presents with symptoms suggestive of heart failure.A single rest MUGA scan (78472) is ordered to assess cardiac function and ejection fraction., A patient with known coronary artery disease undergoes a stress test with a single stress MUGA scan (78472) to evaluate myocardial perfusion and wall motion during stress., A patient is scheduled for chemotherapy known to have cardiotoxic effects. A baseline MUGA (78472) is performed before the initiation of treatment.
Patient history, physical examination findings, indication for the study, images acquired during the procedure, and interpretation report including wall motion assessment and ejection fraction.If pharmacologic stress is used, documentation should include the agent and dose.
** The supply of the radiopharmaceutical is not included in this code and should be billed separately using appropriate HCPCS codes.Additional quantitative processing, such as those that provide more data to help determine severity, might be included in the global billing. This is determined on an individual basis, with many of the modifiers listed applicable.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier may apply depending on the specific billing arrangements and facility.
- Specialties:Cardiology, Nuclear Medicine
- Place of Service:Office, Hospital, Ambulatory Surgical Center