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Reporting PET imaging for cardiac sarcoidosis with radiopharmaceuticals

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Q.

How do we report Positron Emission Tomography (PET) imaging for cardiac sarcoidosis?  We have been unable to successfully get CPT® codes 78459 78451, 78815 preauthorized.

A.

Beginning 1/1/2020, the appropriate CPT code is either 78432 or 78433, depending on whether a PET or PET/CT exam was performed. Both of these codes combine a myocardial perfusion PET with a myocardial viability PET. Two separate radiopharmaceuticals are utilized for this procedure. 

The codes and complete descriptions are as follows:

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 (e.g., 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 (e.g., myocardial viability);with concurrently acquired computed tomography transmission scan