Also is there any recommendation on good websites or books so I can read up on this area of coding?
THIS IS MY SELECTION OF CODES. AM I CORRECT?
93015-Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report
78465-Myocardial perfusion imaging; tomographic (SPECT), multiple studies (including attenuation correction when performed), at rest and/or stress (exercise and/or pharmacologic) and redistribution and/or rest injection, with or without quantification
78478-Myocardial perfusion study with wall motion, qualitative or quantitative study (List separately in addition to code for primary procedure)
78480-Myocardial perfusion study with ejection fraction (List separately in addition to code for primary procedure)
PROCEDURE PERFORMED: Lexiscan thallium stress testing.
INDICATIONS FOR PROCEDURE: A 62-year-old female with a history of mitral valve disease.
PROCEDURE IN DETAIL: The patient was brought to the nuclear suite at which time rest dose of thallium was injected via peripheral vein followed by the rest scan images. For the stress portion a stress dose of Lexiscan was injected via peripheral vein followed by the stress scan and Myoview, followed by the stress scan images. There were no complications.
Hemodynamics. Resting blood pressure 120/90 with a heart rate of 69. During Lexiscan infusion blood pressure was 116/80 with a heart rate of 106. Resting EKG revealed sinus rhythm, otherwise normal EKG. During Lexiscan infusion there were no acute ST-T wave changes. No chest pain with exercise. No arrhythmia with exercise. Reason for termination was completion of protocol.
Gated wall motion analysis revealed a left ventricular ejection fraction of 58% without evidence of segmental wall motion abnormalities.
Perfusion images. SSS score of 9, SRS of 3, SDS of 6. Lung-heart ratio of 0.36. TID score of 1.31. Resting perfusion images showed a moderate area of inferior wall fixed defect. During stress there was partial reversibility of the same region.
IMPRESSION: Lexiscan thallium stress testing significant for:
Left ventricular ejection fraction of 58%.
Perfusion images significant for a moderate area of inferior wall fixed defect with partial reversibility during stress.
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