CPT Code for Diagnostic Adenosine Administration
I cannot provide the specific CPT code for adenosine administration based on the evidence provided, as none of the clinical guidelines, FDA labeling, or research studies contain CPT coding information. The evidence focuses exclusively on clinical indications, dosing protocols, safety profiles, and diagnostic applications of adenosine in cardiac stress testing and arrhythmia management 1, 2.
What the Evidence Does Address
Diagnostic Indications for Adenosine
Adenosine is FDA-approved as a pharmacologic stress agent for myocardial perfusion imaging in patients unable to exercise adequately 2. The ACC/AHA guidelines support its use for:
- Myocardial perfusion SPECT imaging to identify extent, severity, and location of ischemia in patients unable to exercise 1
- Assessment of functional significance of intermediate (25-75%) coronary lesions 1
- Diagnostic evaluation in patients with left bundle branch block when used with vasodilator stress 1
- Myocardial perfusion PET when SPECT studies are equivocal 1
Standard Dosing for Diagnostic Purposes
The FDA-approved dose is 0.14 mg/kg/min infused over 6 minutes as a continuous peripheral intravenous infusion (total dose of 0.84 mg/kg) 2. This regimen has been validated in multiple studies with thallium-201 scintigraphy 3, 4.
How to Obtain the Correct CPT Code
You will need to consult current CPT coding manuals or billing resources, as:
- The procedure code will depend on whether you're billing for the drug administration itself versus the complete stress test procedure
- Separate codes exist for the pharmacologic stress agent administration, the imaging modality (SPECT, PET, echocardiography), and professional interpretation
- HCPCS codes may be required for the adenosine drug supply itself
Common Pitfalls to Avoid
- Do not confuse diagnostic adenosine infusion codes with therapeutic adenosine bolus codes used for SVT termination (which uses 6-12 mg rapid IV push) 5, 6
- Ensure documentation specifies the indication was diagnostic stress testing, not arrhythmia management
- The 6-minute infusion protocol differs fundamentally from the rapid bolus technique for arrhythmias 2, 3
Contact your billing department, coding specialist, or refer to the current year's CPT manual for the accurate procedural code, as these codes are updated annually and vary based on the complete service provided (stress agent administration, imaging, and interpretation components).