Coding for a single-study myocardial perfusion SPECT and multiple studies

Q.

Please explain the difference between the CPT^® codes for a single study myocardial perfusion SPECT (CPT 78451) and multiple studies SPECT (CPT 78452). 

A.

CPT code 78451 is reported when a myocardial perfusion scan with SPECT imaging is performed ONLY at rest, or ONLY at stress. One dose of the radiopharmaceutical is given, and the exam is only performed once. CPT code 78452 is reported when two exams are performed, one is usually performed at rest, and it is repeated after stress. The patient is given two doses of the radiopharmaceutical, one for each study. The most common combination of exams is rest and stress, but rest and redistribution may be performed according to medical necessity. Both exams may be performed on the same day but, based upon facility/practice protocol, may instead be performed on separate dates. If performed on separate dates, you should still report the combination code CPT 78452 and not the individual CPT code (78451) twice.