Table of Contents

Basics of MUGA scan CPT code 78472, 78473, 78494

Multiple-gated acquisition (MUGA) scanning uses radio-labelled red blood cells to scan right and left ventricular images in a cine loop format that is synchronized with the ECG, which requires a regular rhythm for accuracy. Specific procedure codes are reported for this scan. CPT code 78472, 78473, 78494 & +78496 are used for reporting MUGA scan CPT code. This scan helps in evaluating many important function, some are pointed below.

To evaluate left ventricular (LV) function at baseline before chemotherapy or cardiotoxic therapy; may be repeated prior to subsequent chemotherapy cycles until a total cardiotoxic dose has been reached.
To evaluate ejection fraction in a patient with congestive heart failure (CHF).
To evaluate patient, who is obese or who has chronic obstructive pulmonary disease
(COPD), for coronary artery disease (CAD).

Description of MUGA scan CPT code 78472, 78473, 78494 & +78496

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

78473 multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification

In this procedure, radionuclide, which adhere to the patient’s red blood cells, is injected intravenously for cardiac blood pool imaging. Multiple images of the heart, synchronized with the electrocardiographic RR interval (ECG gated), are taken several minutes later, after the radionuclide has spread through the blood pool. These images are computer synthesized and data is generated to produce a video display of cardiac wall motion, calculation of left ventricular ejection fractions, and images based on computer manipulation of the data received. In CPT code 78472, the procedure is performed as a single study at rest or stress, not both; in CPT code 78473, the procedure is performed at both rest and stress. For tests performed during pharmacological or exercise-induced stress, report the appropriate stress testing code also.

CPT code 78472 is reported when a planar MUGA scan at rest or stress is performed, and CPT 78473 is reported when planar MUGA scans, multiple studies at rest and stress is performed.

Planar MUGA studies (CPT 78472 and CPT 78473) should not be reported in conjunction with:

Myocardial Perfusion Imaging MPI (CPT 78451 – CPT 78454)
First pass studies (CPT 78481- CPT 78483)
SPECT MUGA (CPT 78494)

78494 Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing

+78496 Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (List separately in addition to code for primary procedure)

In this procedure same like above radionuclide, which adhere to the patient’s red blood cells, is injected intravenously for cardiac blood pool imaging, gated equilibrium. Multiple SPECT (single photon emission computed tomography) images of the heart, synchronized with the electrocardiographic RR interval (ECG gated), are taken several minutes later, after the radionuclide has spread through the blood pool. These SPECT images are taken by a rotating single or multiple-head camera for three-dimensional views of cross-sectional slices and provide better contrast in imaging and greater accuracy than planar scans. The SPECT images are computer synthesized and data is generated to produce a video display of cardiac wall motion, calculation of ventricular ejection fractions, and images based on computer manipulation of the data received.

Guidelines for MUGA scan CPT code

CPT +78496 is assigned only in conjunction with CPT 78472

The two most commonly performed MUGA scans are the studies defined by CPT 78472 and SPECT MUGA, CPT 78494.

SPECT is major difference between CPT code 78472, 78473 & 78494,78496

Gated blood pool imaging studies are assessed over multiple cardiac cycles. As we learnt above that, this procedure involves binding /tagging the red blood cells with Technetium tc99m.

A9560 Technetium Tc-99m Labeled Red Blood Cell’s (RBC’s), Diagnostic, per study dose, up to 30 mCi’s,

A9560 is the radiopharmaceutical code that should be used for tagging red blood cells. It should be used for both the invitro (Ultratag) and invivo (non-radioactive “cold”pyrophosphate (PYP) followed by an injection of 99m technetium) methods. Regardless of the method used to tag the red blood cells, invitro or invivo, the correct code to use is A9560

As per the coding guidelines the supply of diagnostic and therapeutic radiopharmaceuticals and pharmaceuticals may be reported separately with the appropriate HCPCS Level II code (e.g. A9500-A9700).

Myocardial perfusion (SPECT and PET) and cardiac blood pool imaging studies may be performed at rest and/or during stress. When these procedures are performed together during exercise and/or pharmacologic stress, the appropriate stress testing code from the 93015-93018 series may be reported in addition to 78430, 78431, 78432, 78433, 78451-78454, 78472, 78491, 78492.