Radiology Coding Alert

Question: How should we bill for multiple planar thallium studies or multiple-gated acquisition (MUGA) scans? Ohio Subscriber Answer: Report CPT 78461 (Myocardial perfusion imaging; multiple studies [planar] at rest and/or stress [exercise and/or pharmacologic], and redistribution and/or rest injection, with or without quantification) for multiple thallium studies. Because the descriptor refers to "multiple studies," you don't need to report additional units of the code 78461. If you perform multiple MUGA scans, report 78473 (Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress [exercise and/or pharmacologic], with or without additional quantification). If you perform a single MUGA study, report 78472 (Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress [exercise and/or pharmacologic], wall motion study plus ejection fraction, with or without additional quantitative processing) instead. You may be tempted to report +78478 (Myocardial perfusion study with wall motion, qualitative or quantitative study [list separately in addition to code for primary procedure]) or +78480 (Myocardial perfusion study with ejection fraction [list separately in addition to code for primary procedure]) along with the appropriate perfusion code to receive payment for the wall motion and ejection fraction, but don't report either of these add-on codes, because MUGA studies include both wall motion and ejection fraction.