Cardiac blood pool imaging (procedure codes 4/I/T-78472, 4/I/T-78473, 4/I/T-78481, 4/I/T-78483, 4/I/T-78494, and 4/I/T-78496) is a benefit for the following diagnosis codes:
Diagnosis Codes
3526
3940
3941
3942
3949
3950
3951
3952
3959
3960
3961
3962
3963
3968
3969
3970
3971
3979
41000
41001
41002
41010
41011
41012
41020
41021
41022
41030
41031
41032
41040
41041
41042
41050
41051
41052
41060
41061
41062
41070
41071
41072
41080
41081
41082
41090
41091
41092
4110
4111
41181
41189
412
4130
4131
4139
41400
41401
41402
41403
41404
41405
41406
41407
41410
41411
41412
41419
4142
4148
4149
4150
41511
41519
4160
4161
4168
4169
4170
4171
4178
4179
4200
42090
42091
42099
4210
4211
4219
4220
42290
42291
42292
42293
42299
4230
4231
4232
4238
4239
4240
4241
4242
4243
42490
42491
42499
4250
4251
4252
4253
4254
4255
4257
4258
4259
4260
42610
42611
42612
42613
4262
4263
4264
42650
42651
42652
42653
42654
4266
4267
42681
42682
42689
4269
4270
4271
4272
42731
42732
42741
42742
4275
42760
42761
42769
42781
42789
4279
4280
4281
42820
42821
42822
42823
42830
42831
42832
42833
42840
42841
42842
42843
4289
4290
4291
4292
4293
4294
4295
4296
42971
42979
42981
42982
42989
4299
78099
7813
78650
78651
78652
78659
7991
V4321
V4581
Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved.
