Cardiology Coding Alert

Question: I'm confused about when I should use wall motion code 78478. What should I look for in my physician's documentation?


Tennessee Subscriber


Answer: You should report +78478 (Myocardial perfusion study with wall motion, qualitative or quantitative study [list separately in addition to code for primary procedure]) when your cardiologist evaluates the motion of the left ventricle. Code 78478 represents the actual assessment of watching the ventricle contract and relax.

Your physician must include words like "wall motion," "hypokinesis," "dyskinesia" and "akinesia." All of these terms will demonstrate wall motion.

Remember: You should use this add-on code with myocardial perfusion imaging codes (78460-78465).

Best bet: If you encounter denials for wall motion claims (78478), point out that the study helps physicians distinguish between perfusion defects and other soft-tissue artifacts, such as diaphragmatic attenuation or breast attenuation.