Cardiology Question for the Week of October 28, 2019

Cardiology Compliance Question of the Week


Do the cardiac positron emission tomography (PET) codes include wall motion (WM) and ejection fraction (EF)?


The 2019 cardiac PET codes do not include wall motion and ejection fraction. If your patient has insurance other than Medicare fee-for-service, you can add unlisted code 78499 to account for WM and EF. For Medicare fee-for-service patients, WM and EF are not specifically included in the Medicare coverage policy for PET, so it is considered non-covered. You can report code G0235 (PET imaging, any site, not otherwise specified) if you wish to include it on your claim. The revised and new cardiac PET codes for 2020 specifically include WM and EF when performed.