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Coding for when a coronary perfusion PET and a myocardial viability scan are performed together

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Q.

We have begun performing cardiac PET Scans for sarcoidosis. We perform both a perfusion scan and a metabolic (myocardial viability) scan. Can we assign both CPT® code 78459 and 78492? 

A.

As of January 1, 2020, there are now two combination CPT codes for when both a coronary perfusion PET and a myocardial viability scan are performed together. Those options are CPT 78432 (combined PET), and CPT 78433 (combined PET/CT). The CPT codes and full descriptions are:

78432 Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);

78433 Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan