J708 – Cardiac PET with quantitative analysis
OHIP Cardio-Thoracic Surgery Code — POSITRON EMISSION TOMOGRAPHY (PET) · Schedule of Benefits
Adds quantitative analysis to J707. This service is for cardiac PET scans using fluorodeoxyglucose (FDG) for myocardial viability assessment in patients who have moderate to severe ischemic left ventricular dysfunction (left ejection fraction ≤ 40%) despite maximal medical therapy, and are suitable candidates for cardiac revascularization or transplantation. See 'Notes' for additional medical necessity criteria.
When to Use
- Use J708 as an add-on to J707 specifically when performing quantitative analysis for myocardial viability in patients with an LVEF ≤ 40% who are candidates for revascularization.
- Apply this code when a prior SPECT or dobutamine stress echo provided equivocal results regarding myocardial viability, necessitating the higher resolution of PET quantitative analysis.
Common Pitfalls
- Billing J708 without an associated J707 claim on the same day will result in a rejection, as it is strictly an add-on service.
- Submitting J708 for patients with an LVEF > 40% or those who are not candidates for revascularization or transplantation will trigger an audit due to failure to meet the strict medical necessity criteria.
- Attempting to bill J708 alongside restricted codes like J700 or J709 will lead to automatic claim denial.
Billing Tips
- Always ensure the professional component is submitted with the 'C' suffix to comply with the specific billing requirements for PET professional services.
- Document the specific LVEF percentage and the prior equivocal imaging modality in the patient record to justify the necessity of the quantitative analysis performed under J708.
Effective: October 1, 2009
B. Nuclear Medicine - IN VIVO
POSITRON EMISSION TOMOGRAPHY (PET)
PercentageIncrease
Positron Emission Tomography (PET)
PET is an insured service for the clarification of myocardial viability when: a.a previous myocardial imaging assessment has been rendered, using another modality (e.g. SPECT using thallium, MIBI or dobutamine stress echocardiography) and the result of the previous imaging assessment was equivocal or demonstrated insufficient viable myocardium; or b.a patient with a left ventricular ejection fraction less than 35% and known multi-vessel coronary disease determined by coronary angiography urgently needs an assessment of myocardial viability.
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