# Lexiscan thallium stress testing



## daniel

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


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## 634sg4fs65g4fg

*Nuclear codes*

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


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