Coding myocardial perfusion imaging that already includes SPECT

Q.

Please advise if CPT^® code 78452 should be assigned with CPT code 78830. The technique states: A stress protocol was used. 12 mCi of Tc-99m Tetrofosmin was administered intravenously at rest and 43.2 mCi was administered intravenously at stress. Gated SPECT images were obtained and processed. CT images were obtained through the heart. LIMITATIONS: No prone images were obtained. The low-dose CT acquisition was performed only for attenuation correction/activity localization. There is no intravenous contrast, further limiting the CT component of the study.

A.

No, you would only assign CPT code 78452. 

CPT code 78452 already includes SPECT, so if you also assign CPT code 78830 you are coding SPECT twice. 

In addition, your doctor said they did the CT for attenuation correction (“The low-dose CT acquisition was performed only for attenuation correction/activity localization”), and the code description for CPT 78452 specifically includes attenuation correction when performed. 

The code and full description are:

78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection