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Thread: Lexiscan thallium stress testing

  1. #1
    Join Date
    Apr 2007
    Posts
    507

    Default Lexiscan thallium stress testing

    Promo: Code Books
    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)

    A9504-THALLIUM

    J2785-LEXISCAN













    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.

    FINDINGS:
    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.


    Thank You
    Daniel,CPC

  2. #2

    Default Nuclear codes

    Yes, that is the bundle we use for our nuks. Good luck!

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