Cardiology Coding Alert

Question: How should I report the following case? A patient with an abnormal ECG presents for SPECT imaging at rest with 15 mCi of Tc-99m sestamibi. Then the patient received 6 mg of adenosine and another dose of Tc-99m sestamibi for stress imaging (non-gated). We provide the full stress test service.Missouri SubscriberAnswer: If the cardiologist documents a diagnosis based on the test, you should code that diagnosis. If not, you should report the code that represents the reason for the test. In this case, that is the abnormal electrocardiogram (ECG), for which you should report 794.31 (Nonspecific abnormal electrocardiogram [ECG] [EKG]).To report the SPECT imaging both at rest and stress, report a single unit of 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] [...]