Summary & Overview

CPT 0332T: SPECT Myocardial Sympathetic Innervation Imaging

CPT code 0332T represents SPECT myocardial sympathetic innervation imaging, a specialized nuclear medicine study that assesses cardiac neuronal integrity. This clinically focused imaging procedure is used to evaluate sympathetic innervation of the myocardium, which can inform diagnosis and management of certain cardiac conditions. Nationally, the code matters as an emerging functional cardiac imaging service with implications for specialty imaging centers and hospital outpatient departments.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage patterns, reimbursement benchmarks, typical sites of service, and relevant clinical context for the use of this SPECT procedure. The publication summarizes common modifiers and coding considerations, highlights where data are available or absent, and outlines how this service fits into cardiac diagnostic pathways.

The report is intended for health system billing teams, revenue cycle leaders, and clinical program managers seeking a concise reference to CPT code 0332T, including operational implications for performing and billing SPECT myocardial sympathetic innervation imaging. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0332TCPTnuclear medicinecardiac imagingSPECTmyocardial innervationimaging billinghospital outpatientrevenue cycle

Billing Code Overview

CPT code 0332T describes SPECT myocardial sympathetic innervation imaging. This service uses single-photon emission computed tomography (SPECT) to evaluate the sympathetic innervation of the myocardium, a functional nuclear medicine imaging study that assesses cardiac neuronal integrity.

Service Type: Nuclear medicine imaging — cardiac sympathetic innervation assessment

Typical Site of Service: Hospital outpatient imaging center or dedicated nuclear medicine facility

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 68-year-old male with ischemic cardiomyopathy, reduced left ventricular ejection fraction, and recurrent ventricular arrhythmias is referred for SPECT myocardial sympathetic innervation imaging using radiotracer and single-photon emission computed tomography to assess regional sympathetic denervation. The typical workflow begins with pre-procedure screening (history, medication review, and informed consent), withholding interfering medications per nuclear medicine protocol, and IV access for tracer injection. The patient is positioned in the nuclear medicine camera room; tracer uptake period is observed per protocol (often several hours), followed by SPECT acquisition with ECG gating as indicated. Image reconstruction and quantitative analysis are performed by the interpreting nuclear cardiologist or nuclear medicine physician. Findings are documented in the radiology/nuclear medicine report and communicated to the referring cardiology team for integration into decision-making regarding device therapy (e.g., implantable cardioverter-defibrillator), ablation planning, or medical management.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing for the physician interpretation/report only, with technical component billed separately.
`TC`	Technical component	Use when billing for equipment, technician, and radiopharmaceutical costs only, without interpretation.
`52`	Reduced services	Use when the study is partially reduced in scope (limited acquisition) compared with full protocol.
`53`	Discontinued procedure	Use when the imaging study is started but terminated due to patient instability or adverse event.
`76`	Repeat procedure by same physician	Data not available in the input.
`77`	Repeat procedure by another physician	Data not available in the input.
`22`	Increased procedural services	Use when work required is substantially greater than typical (complex positioning, prolonged acquisition/reconstruction).
`62`	Two surgeons	Data not available in the input.
`82`	Assistant not available	Use when an assistant surgeon usually required is not available — rarely applicable to imaging but included per payer-specific rules.
`QK`	Medical courier service	Use when specialized courier or handling of radiopharmaceutical requires separate billing under applicable payor rules.

Taxonomy Code	Specialty	Notes
208100000X	Nuclear Medicine Physician	Interprets SPECT myocardial sympathetic innervation studies and signs reports.
207RC0000X	Cardiovascular Disease (Cardiology)	Refers patients for testing and integrates results into cardiac care plans.
2083P0200X	Radiology—Diagnostic	May perform and interpret nuclear cardiac studies in some settings.
335700000X	Nuclear Medicine Technologist	Performs radiotracer administration and image acquisition (listed as provider role rather than taxonomy code for billing).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.22`	Chronic systolic (congestive) heart failure	Left ventricular systolic dysfunction is associated with sympathetic denervation and arrhythmic risk evaluated by this study.
`I49.01`	Ventricular fibrillation	Prior malignant ventricular arrhythmias prompt evaluation of myocardial innervation to guide therapy.
`I46.9`	Cardiac arrest, cause unspecified	Survivors of cardiac arrest may undergo sympathetic imaging for risk stratification.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Ischemic heart disease is a common substrate for regional sympathetic denervation.
`I42.0`	Dilated cardiomyopathy	Nonischemic cardiomyopathies also demonstrate altered sympathetic innervation relevant to management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`78451`	Myocardial perfusion imaging, single study, planar or SPECT, rest or stress	Performed alongside myocardial innervation imaging when concurrent assessment of perfusion is needed to correlate denervation with ischemia.
`78452`	Myocardial perfusion imaging, multiple studies, same radiopharmaceutical, with quantitative assessment	Used when rest and stress perfusion studies are required in the same patient on the same day.
`71045`	Radiologic examination, chest, single view, frontal	May be performed pre-procedure for routine evaluation of pulmonary status or radiographic guidance when needed.
`93010`	Electrocardiogram, interpretation and report only	ECG gating or correlation with arrhythmia monitoring is often performed and documented with the imaging study.
`93798`	Physician or other qualified health care professional remote physiologic monitoring treatment management services	May be used in longitudinal management when imaging informs device therapy and follow-up monitoring plans.