Under ICD-10 Codes That Support Medical Necessity for Cardiac Blood Pool Imaging (MUGA, Ventriculography) added ICD-10 codes T45.1X5A, T45.1X5D, T45.1X5S and Z01.89 with asterisks and added a *Note. Under Sources of Information and Basis for Decision corrected the page numbers cited for the Federal Register 1997;62(211):59058-59260.
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M79.1 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. The 2021 edition of ICD-10-CM M79.1 became effective on October 1, 2020. This is the American ICD-10-CM version of M79.1 - other international versions of ICD-10 M79.1 may differ.
2018/2019 ICD-10-CM Diagnosis Code M79.1. Myalgia. M79.1 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. ICD-10-CM M79.1 is a new 2019 ICD-10-CM code that became effective on October 1, 2018.
G21.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2018/2019 edition of ICD-10-CM G21.0 became effective on October 1, 2018. This is the American ICD-10-CM version of G21.0 - other international versions of ICD-10 G21.0 may differ.
The 2022 edition of ICD-10-CM R94.39 became effective on October 1, 2021. This is the American ICD-10-CM version of R94.39 - other international versions of ICD-10 R94.39 may differ.
Prior Authorizations for MUGA Scan and Myocardial Perfusion ImagingAuthorized CPT CodeDescriptionAllowable Billed Groupings78472MUGA Scan78472, 78473, 78494, 7849678451Myocardial Perfusion Imaging – Nuclear Cardiology Study78451, 78452, 78453, 78454, 78466, 78468, 78469, 78481, 78483, 78499Feb 17, 2020
But how each test generates images is fundamentally different: A MUGA scan is a nuclear medicine test that uses gamma rays and a chemical tracer to generate images of your heart. An echocardiogram uses high-frequency sound waves and a transducer with a special gel to generate ultrasound images of your heart.
The MUGA scan measures the amount of blood pumped out of your ventricles. A result of 50% to 75% is considered in the normal range. This means that your heart is efficiently pumping blood throughout your body.
A MUGA scan—the acronym for multiple gated acquisition scan—is a noninvasive, nuclear medicine test used to examine the ventricles (lower chambers) of the heart. It uses gamma rays and a radioactive tracer to create a computerized image of the heart as it beats.
Assessment of the orientation of the heart and great vessels in the chest. Undiagnosed ischemic disease in the absence of myocardial infarction with hypodynamic wall motion. Determination of systolic or diastolic dysfunction in undiagnosed congestive heart failure patients by viewing ventricular filling and contraction.
A multiple-gated acquisition (MUGA) scan is a nuclear medicine test that shows how much blood your heart pumps with each heartbeat. An “exercise” or “stress” MUGA scan helps the doctor see how your heart handles hard work. A “resting” MUGA scan shows how well your heart pumps blood when you're lying still.
MUGA LVEFs are only modestly accurate when compared with reference LVEFs from CMR. At LVEF thresholds of 50 and 55%, there is misclassification of 35 and 20% of cancer patients, respectively, to either normal or abnormal categories.
MUGA LVEFs are only modestly accurate when compared with reference LVEFs from CMR. At LVEF thresholds of 50 and 55%, there is misclassification of 35 and 20% of cancer patients, respectively, to either normal or abnormal categories.
The ejection fraction is usually measured only in the left ventricle. The left ventricle is the heart's main pumping chamber. It pumps oxygen-rich blood up into your body's main artery (aorta) to the rest of the body. A normal ejection fraction is about 50% to 75%, according to the American Heart Association.
The 2022 edition of ICD-10-CM Z51.11 became effective on October 1, 2021.
838 Chemotherapy with acute leukemia as secondary diagnosis with cc or high dose chemotherapy agent
Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00 -Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
The 2022 edition of ICD-10-CM G21.0 became effective on October 1, 2021.
In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere.". Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code.
Abnormal result of cardiovascular function study, unspecified 1 R94.30 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 Short description: Abnormal result of cardiovascular function study, unsp 3 The 2021 edition of ICD-10-CM R94.30 became effective on October 1, 2020. 4 This is the American ICD-10-CM version of R94.30 - other international versions of ICD-10 R94.30 may differ.
The 2022 edition of ICD-10-CM R94.30 became effective on October 1, 2021.
Under Coverage Indications, Limitations and /or Medical Necessity removed quoted Internet Only Manual (IOM) text and changed verbiage to read “Positron emission tomography (PET) scans performed for the diagnosis and management of patients with known or suspected coronary artery disease, using Food and Drug Administration (FDA) approved Rubidium 82 (Rb 82), are covered when the following conditions are met: The PET scan (at rest or rest with stress) is perform ed in place of SPECT ; or is performed following and inconclusive SPECT (results that are equivocal, technically uninterpretable, or discordant with the patient’s other clinical data). In such cases the PET scan must have been determined to be medically necessary to guide further treatment of the patient. When a PET scan is performed as an additional diagnostic test in the instance of an equivocal SPECT, the reason for performing the PET scan must be clearly documented in the patient’s record.” which starts in the fourth paragraph. Under the subheading Indication for Myocardial Perfusion Imaging removed italics from all five headings. Under Bibliography changes were made to citations to reflect AMA citation guidelines. Formatting, punctuation and typographical errors were corrected, acronyms were inserted, and CPT ® was inserted throughout the LCD where applicable.
2. Unstable angina - MPI may be useful as an adjunct to other tests in the diagnosis or treatment of unstable angina only when the combination of history and other tests is not diagnostic. In selected patients, imaging is appropriate for:
CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Ventriculography is sometimes referred to as multiple gated acquisition scanning (MUGA) or cardiac blood pool imaging and is primarily used to evaluate valvular disease and cardiomyopathies. When billing claims for Cardiac Radionuclide Imaging for cardiac blood pool imaging (MUGA, ventriculography) for patients receiving cardiotoxic chemotherapy use the following CPT codes: 78472, 78473, 78481, 78483, 78494, 78496 Coding for Cardiac Blood Pool Imaging (MUGA, Ventriculography) for Cardiac Radionuclide Imaging: Prior to the initiation of cardiotoxic chemotherapy: Code Z01.89- Encounter for other specified special examinations and the appropriate code from the C code or D code family During or for interval assessment of cardiotoxic chemotherapy use the appropriate code for the encounter: T45.1X5A Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter T45.1X5D Adverse effect of antineoplastic and immunosuppressive drugs, subsequent encounter T45.1X5S Adverse effect of antineoplastic and immunosuppressive drugs, sequela At the completion of cardiotoxic chemotherapy: Code Z08- Encounter for follow-up examination after completed treatment for malignant neoplasm Use the additional secondary code to identify the personal history of malignant neoplasm (Z85.-) as per Correct Coding Initiative (CCI) guidelines and the appropriate code from the C code or D code family. *For appropriate C codes, D codes and appropriate Z85.- codes for billing cardiac blood pool imaging (MUGA, ventriculography) refer to the Covered ICD-10 Codes section of this article..
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.