Billing and Coding: Cardiovascular Nuclear Medicine

Medicare Coverage Database article A56494

Article

Contractor: CGS Administrators, LLC
States (A/B MAC): KY, OH
Effective: Jan 29, 2026
Contractor numbers: 15101, 15102, 15201, 15202
Official article: A56494 on cms.gov (version 17)

Read the article's coding instructions on CMS — which codes go together, documentation, and frequency limits — before billing. CodeRx lists the codes, not the instructions.

Drug codes in this article

HCPCS Level II drug codes the article lists (other codes it lists are not shown).

Covered ICD-10-CM codes (159)

Diagnosis codes the article lists as supporting medical necessity, grouped as in the article, with CMS's descriptions.

Group 1 · 125 codes

I20.0Unstable angina
I20.1Angina pectoris with documented spasm
I20.81Angina pectoris with coronary microvascular dysfunction
I20.89Other forms of angina pectoris
I20.9Angina pectoris, unspecified
I21.01ST elevation (STEMI) myocardial infarction involving left main coronary artery
I21.02ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
I21.11ST elevation (STEMI) myocardial infarction involving right coronary artery
I21.19ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
I21.21ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery
I21.29ST elevation (STEMI) myocardial infarction involving other sites
I21.3ST elevation (STEMI) myocardial infarction of unspecified site
I21.4Non-ST elevation (NSTEMI) myocardial infarction
I22.0Subsequent ST elevation (STEMI) myocardial infarction of anterior wall
I22.1Subsequent ST elevation (STEMI) myocardial infarction of inferior wall
I22.2Subsequent non-ST elevation (NSTEMI) myocardial infarction
I22.8Subsequent ST elevation (STEMI) myocardial infarction of other sites
I22.9Subsequent ST elevation (STEMI) myocardial infarction of unspecified site
I23.7Postinfarction angina
I23.8Other current complications following acute myocardial infarction
I24.0Acute coronary thrombosis not resulting in myocardial infarction
I24.1Dressler's syndrome
I24.81Acute coronary microvascular dysfunction
I24.89Other forms of acute ischemic heart disease
I24.9Acute ischemic heart disease, unspecified
I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.112Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
I25.118Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.2Old myocardial infarction
I25.3Aneurysm of heart
I25.41Coronary artery aneurysm
I25.42Coronary artery dissection
I25.5Ischemic cardiomyopathy
I25.6Silent myocardial ischemia
I25.700Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris
I25.701Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
I25.702Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris
I25.708Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
I25.709Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
I25.710Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
I25.711Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.712Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris
I25.718Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
I25.719Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris
I25.720Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
I25.721Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.722Atherosclerosis of autologous artery coronary artery bypass graft(s) with refractory angina pectoris
I25.728Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris
I25.729Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris
I25.730Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris
I25.731Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.732Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with refractory angina pectoris
I25.738Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris
I25.739Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris
I25.750Atherosclerosis of native coronary artery of transplanted heart with unstable angina
I25.751Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm
I25.752Atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris
I25.758Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris
I25.759Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
I25.760Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina
I25.761Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm
I25.762Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris
I25.768Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris
I25.769Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris
I25.790Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris
I25.791Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.792Atherosclerosis of other coronary artery bypass graft(s) with refractory angina pectoris
I25.798Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris
I25.799Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris
I25.811Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
I25.812Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
I25.82Chronic total occlusion of coronary artery
I25.83Coronary atherosclerosis due to lipid rich plaque
I25.84Coronary atherosclerosis due to calcified coronary lesion
I46.2Cardiac arrest due to underlying cardiac condition
I46.8Cardiac arrest due to other underlying condition
I49.01Ventricular fibrillation
I49.02Ventricular flutter
I50.1Left ventricular failure, unspecified
I50.21Acute systolic (congestive) heart failure
I50.22Chronic systolic (congestive) heart failure
I50.23Acute on chronic systolic (congestive) heart failure
I50.31Acute diastolic (congestive) heart failure
I50.32Chronic diastolic (congestive) heart failure
I50.33Acute on chronic diastolic (congestive) heart failure
I50.41Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I51.81Takotsubo syndrome
I51.89Other ill-defined heart diseases
Q24.5Malformation of coronary vessels
R06.00Dyspnea, unspecified
R06.01Orthopnea
R06.02Shortness of breath
R06.09Other forms of dyspnea
R06.1Stridor
R06.2Wheezing
R06.4Hyperventilation
R07.2Precordial pain
R07.82Intercostal pain
R07.89Other chest pain
R07.9Chest pain, unspecified
R94.31Abnormal electrocardiogram [ECG] [EKG]
T82.817AEmbolism due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.827AFibrosis due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.837AHemorrhage due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.847APain due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.857AStenosis of other cardiac prosthetic devices, implants and grafts, initial encounter
T82.867AThrombosis due to cardiac prosthetic devices, implants and grafts, initial encounter
T86.21Heart transplant rejection
T86.22Heart transplant failure
T86.23Heart transplant infection
T86.290Cardiac allograft vasculopathy
T86.31Heart-lung transplant rejection
T86.32Heart-lung transplant failure
T86.33Heart-lung transplant infection
Z01.810Encounter for preprocedural cardiovascular examination
Z94.1Heart transplant status
Z95.1Presence of aortocoronary bypass graft
Z95.5Presence of coronary angioplasty implant and graft
Z98.61Coronary angioplasty status

Group 2 · 15 codes

I50.21Acute systolic (congestive) heart failure
I50.22Chronic systolic (congestive) heart failure
I50.23Acute on chronic systolic (congestive) heart failure
I50.41Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
Z01.30Encounter for examination of blood pressure without abnormal findings
Z01.31Encounter for examination of blood pressure with abnormal findings
Z01.818Encounter for other preprocedural examination
Z01.82Encounter for allergy testing
Z08Encounter for follow-up examination after completed treatment for malignant neoplasm
Z09Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z51.11Encounter for antineoplastic chemotherapy
Z51.12Encounter for antineoplastic immunotherapy
Z51.81Encounter for therapeutic drug level monitoring

Group 3 · 19 codes

I21.01ST elevation (STEMI) myocardial infarction involving left main coronary artery
I21.02ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
I21.11ST elevation (STEMI) myocardial infarction involving right coronary artery
I21.19ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
I21.21ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery
I21.29ST elevation (STEMI) myocardial infarction involving other sites
I21.3ST elevation (STEMI) myocardial infarction of unspecified site
I21.4Non-ST elevation (NSTEMI) myocardial infarction
I22.0Subsequent ST elevation (STEMI) myocardial infarction of anterior wall
I22.1Subsequent ST elevation (STEMI) myocardial infarction of inferior wall
I22.2Subsequent non-ST elevation (NSTEMI) myocardial infarction
I22.8Subsequent ST elevation (STEMI) myocardial infarction of other sites
I22.9Subsequent ST elevation (STEMI) myocardial infarction of unspecified site
I25.82Chronic total occlusion of coronary artery
R07.2Precordial pain
R07.82Intercostal pain
R07.9Chest pain, unspecified
R94.31Abnormal electrocardiogram [ECG] [EKG]

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