AMA Announces New CPT Category III Code for PET Absolute Quantification of Myocardial Blood Flow

As ASNC announced earlier this year, the American Medical Association's Current Procedural Terminology (CPT®) Editorial Panel has approved a category III billing code for PET absolute quantitation of myocardial blood flow, effective Jan. 1, 2018.

This is an important early step in accurate billing and reimbursement for this service. Much advocacy work remains to be done, however.

Unlike permanent category I CPT codes, category III CPT codes (also called “temporary” codes or “tracking” codes) are used for emerging technologies and procedures to allow tracking as these new services become better established. In fact, it is not proper to use a different code, such as an unlisted code, if the category III code applies.

Watch for more tips from ASNC about how to approach local carriers and for tools to use in this advocacy effort.

The new CPT code language is provided below: 

This is an add-on code, which means that it must be reported in conjunction with the codes for PET myocardial perfusion, 78491 or 78492. Code +0482T would be expected to be reported on the same day as codes 78491 / 78492.The establishment of this category III code is an important step.The requirement for a category I CPT code with subsequent relative values in the Medicare physician fee schedules will require widespread use of the service and more advocacy by the ASNC community.

Effective Jan. 1, 2018
+0482T Absolute quantitation of myocardial blood flow, positron emission tomography (PET), rest and stress (list separately in addition to code for primary procedure)
Use 0482T in conjunction with 78491, 78492.
For myocardial imaging metabolic evaluation, use 78459.
For positron emission tomography (PET) myocardial perfusion study, see 78491, 78492.