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Archival of policy regarding myocardial perfusion imaging

February 3, 2020

Effective March 30, 2020, the following Independence policies will be archived:

  • Commercial: #03.02.12c: Electrocardiogram (ECG/EKG) Reported with Single Photon Emission Computed Tomography (SPECT) for Myocardial Perfusion Imaging (MPI)
  • Medicare Advantage: #MA03.015: Electrocardiogram (ECG/EKG) Reported with Single Photon Emission Computed Tomography (SPECT) for Myocardial Perfusion Imaging (MPI)

Reason for policy archival

Independence follows Medicare Correct Coding Initiative (CCI) Code Pair Edits, and the following CPT® procedure codes will be applied to the reporting of ECG/EKG codes in conjunction with SPECT for MPI:

Service type Procedure codes

ECG/EKG

  • 93000
  • 93005
  • 93010

SPECT for MPI

  • 78451
  • 78452

Learn more

Advance notification of archival was posted on the Medical Policy Portal on December 27, 2019. To view these Notifications, visit the Medical Policy Portal.

For more information about NCCI coding, please review the following policies on our Medical Policy Portal:

  • Commercial: #00.01.56a: National Correct Coding Initiative (NCCI) Code Pair Edits
  • Medicare Advantage: #MA00.041: National Correct Coding Initiative (NCCI) Code Pair Edits

CPT Copyright 2017 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.

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