Cardiology Coding Alert

Question: How should I report the interpretation of nuclear images performed for a SPECT Cardiolite test? The test was performed at a hospital. Documentation shows resting images only with no gating.

 New Hampshire Subscriber

Answer:  You should report 78451 (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]) for the nuclear study. Remember to append modifier 26 (Professional component) for your physician’s interpretation. The hospital will bill for the technical component and Cardiolite supply.

Use this single-study code because the test involved resting images only, not stress images. Although there was no gating, the coding won’t change. Code 78451’s definition states that ejection fraction by gated technique is included in the code if performed, but it isn’t required for the code to apply.