Summary & Overview

CPT 0742T: Absolute Quantitation of Myocardial Blood Flow (SPECT Add-on)

CPT code 0742T designates absolute quantitation of myocardial blood flow (AQMBF) performed as an add-on to a primary SPECT myocardial perfusion imaging study, typically acquired under pharmacologic or exercise-induced stress and optionally at rest. This measurement provides quantitative blood flow metrics that can enhance diagnostic precision for ischemia and coronary flow abnormalities beyond standard qualitative perfusion images. Nationally, adoption of quantitative myocardial blood flow measures is growing as imaging centers and payers evaluate clinical utility and coding clarity for advanced nuclear cardiology techniques.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines coverage and billing considerations seen across major commercial payers and federal programs, highlighting areas where policy language, bundling guidance, and documentation expectations matter for correct use of an add-on code.

Readers will learn the clinical context for using CPT code 0742T, typical sites of service, and the role of AQMBF in complementing SPECT perfusion studies. The report provides benchmarks and policy-relevant observations about payer coverage patterns, documentation points that support medical necessity, and how this add-on service fits within cardiac imaging service lines. Data limitations are noted where input details were not provided.

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Billing Code Overview

CPT code 0742T is an add-on imaging code used when a provider performs absolute quantitation of myocardial blood flow (AQMBF) as part of a primary SPECT myocardial perfusion imaging study. The service is performed under stress conditions and may also be performed at rest when clinically indicated.

Service Type: Cardiac nuclear imaging — quantitative myocardial blood flow measurement (add-on to primary SPECT perfusion study)

Typical Site of Service: Outpatient imaging center or hospital outpatient department, where SPECT myocardial perfusion studies are performed using nuclear medicine facilities and personnel.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 62-year-old male with exertional chest pain, hypertension, and known coronary artery disease being evaluated for ischemia. The patient presents to an outpatient nuclear cardiology laboratory for a single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) study with pharmacologic or exercise stress. The technologist administers radiopharmaceuticals and performs gated SPECT acquisition. As an add-on to the primary SPECT MPI study, the interpreting physician performs absolute quantitation of myocardial blood flow (0742T) during the stress portion and, if indicated by protocol, at rest. The workflow includes pre-test clinical assessment, medication reconciliation, informed consent, stress administration (exercise or pharmacologic), SPECT image acquisition, image processing with software that generates quantitative myocardial blood flow values, and physician interpretation with a formal report documenting absolute flow values, flow reserve if rest images are obtained, and comparison to prior studies when available. Typical sites of service are outpatient imaging centers, hospital-based nuclear medicine or cardiology departments, and ambulatory surgery centers when coupled with other procedures. Common clinical indications include evaluation of suspected or known ischemic heart disease, assessment of microvascular dysfunction, and pre-operative cardiac risk assessment.

Coding Specifications

Modifier	Description	When to Use
`26`

Taxonomy Code	Specialty	Notes
207RC0000X	Nuclear Cardiology Medicine	Physicians who interpret SPECT MPI and perform quantitative flow analysis.
2080P0207X	Cardiovascular Disease	Cardiologists who order and interpret MPI and AQMBF data.
2085S0101X	Nuclear Medicine	Nuclear medicine physicians who oversee radiopharmaceutical administration and image interpretation.
363L00000X	Radiology – Diagnostic Radiology	Diagnostic radiologists with nuclear imaging expertise who may interpret SPECT MPI and quantitative flow studies.

ICD-10 Code	Description	Clinical Relevance
`I20.9`	Angina pectoris, unspecified	Common indication for SPECT MPI and assessment of myocardial blood flow to evaluate ischemia.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Used for patients with known CAD undergoing evaluation of perfusion and flow reserve.
`I48.91`	Unspecified atrial fibrillation	Patients with arrhythmia may undergo risk stratification with MPI prior to procedures; arrhythmia can affect image quality and interpretation.
`R07.9`	Chest pain, unspecified	Symptom prompting ischemia evaluation with SPECT MPI and AQMBF.
`I50.9`	Heart failure, unspecified	Used when MPI is performed as part of evaluation of ischemic contribution to heart failure symptoms.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`78452`	Myocardial perfusion imaging, tomographic (SPECT) with quantitative or qualitative planar imaging, single study (rest OR stress)	Primary SPECT MPI study to which `0742T` is an add-on for absolute quantitation of myocardial blood flow; the base study provides image acquisition and interpretation.
`78451`	Myocardial perfusion imaging, tomographic (SPECT) with quantitative or qualitative planar imaging, multiple studies (e.g., rest and stress)	Used when both rest and stress SPECT acquisitions are performed; absolute quantitation (`0742T`) may be reported in addition to the base multi-study code.
`93000`	Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Performed immediately before stress testing to document baseline rhythm and for safety screening prior to stress administration.
`93015`	Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, including continuous ECG monitoring, interpretation and report	Exercise stress component that may be used with SPECT MPI and AQMBF measurement when exercise stress is feasible.
`93351`	Dobutamine stress echocardiography, including imaging, interpretation and report	Alternative stress imaging modality; included to show related non-nuclear stress testing options in the cardiac imaging workflow.

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