CPT® Code 0399T

Deleted

Myocardial strain imaging (quantitative assessment of myocardial mechanics using image-based analysis of local myocardial dynamics) (List separately in addition to code for primary procedure)

The CPT® Code 0399T refers to a specialized procedure known as myocardial strain imaging, which involves a quantitative assessment of myocardial mechanics through image-based analysis of local myocardial dynamics. This non-invasive technique utilizes echocardiography, specifically employing two-dimensional (2D) speckle tracking, to evaluate the function of the heart muscle, particularly the left ventricle (LV). The procedure measures various types of deformation—longitudinal, radial, and circumferential—of the LV during both the contraction (systole) and relaxation (diastole) phases of the cardiac cycle. Myocardial strain imaging serves multiple clinical purposes, including the quantification of myocardial dysfunction, assessment of myocardial viability, and detection of acute allograft rejection and early allograft vasculopathy in patients who have undergone heart transplantation. Additionally, this imaging technique can be instrumental in identifying sub-clinical cardiac manifestations in patients with conditions such as diabetes, systemic sclerosis, myocardial ischemia, arterial hypertension, and valvular heart diseases like mitral or aortic regurgitation. It is also valuable in the context of non-ischemic cardiomyopathies and can aid in predicting outcomes for patients experiencing acute heart failure. The procedure involves obtaining ultrasound images with electrocardiogram (ECG) gating from various views, including the apical four-chamber, three-chamber, and two-chamber views, as well as short-axis views at the basal, mid, and apical levels, ensuring a minimum of three cardiac cycles for each imaging loop. During the imaging process, patients are instructed to hold their breath to enhance image quality. Advanced software is then utilized to analyze the acquired images by tracking natural acoustic markers, known as speckles, in the 2D ultrasound. This tracking occurs frame by frame, allowing for the calculation of velocity and strain rate based on the observed cardiac motion. It is important to report code 0399T separately as an adjunct to a primary echocardiography procedure to ensure accurate coding and billing for this specialized assessment.