Lexi Stress Test: Procedure, CPT Code, Side Effects, Nuclear & Heart Imaging Guide

Content:

• Lexi Stress Test Procedure
• Lexi Stress Test CPT Code
• Lexi Stress Test Side Effects
• Lexi Stress Test Nuclear Imaging
• Lexi Stress Test Heart Imaging Guide

Lexi Stress Test Procedure

The Lexiscan stress test, often called the “Lexi stress test,” is a type of pharmacologic nuclear stress test used to evaluate blood flow to the heart muscle. Instead of exercise on a treadmill, the test uses a medication called regadenoson (brand name: Lexiscan) to stimulate the heart and increase blood flow similar to what happens during physical activity.

During the procedure, the patient receives an intravenous (IV) injection of Lexiscan, followed by a radioactive tracer (such as technetium-99m sestamibi). Special gamma cameras then take images of the heart at rest and under stress. The test typically takes 2–4 hours and is used to diagnose coronary artery disease, assess heart function, and evaluate blood flow patterns.

Preparation usually involves fasting for a few hours, avoiding caffeine for at least 12–24 hours, and holding certain medications as advised by the doctor. The patient lies still while images are captured, and vital signs are monitored throughout.

Lexi Stress Test CPT Code

The CPT code for the Lexiscan stress test depends on whether it includes imaging. Commonly used codes include:

• 78452 – Myocardial perfusion imaging, tomographic (SPECT), multiple studies (rest and stress), with attenuation correction and/or gating, when performed.
• 93015 – Cardiovascular stress test using treadmill, bicycle, or pharmacologic stress (including supervision, interpretation, and report).
• J2785 – Injection of regadenoson (Lexiscan), 0.1 mg.

These codes may be billed together or separately, depending on the provider’s documentation and payer guidelines.

Lexi Stress Test Side Effects

Although generally safe, Lexiscan can cause temporary side effects due to its vasodilatory action on coronary arteries. Common side effects include:

• Flushing or warmth
• Shortness of breath
• Headache
• Dizziness or lightheadedness
• Nausea
• Chest discomfort

These symptoms are usually mild and resolve within minutes. Rare but serious reactions may include hypotension, arrhythmias, or bronchospasm. An antidote (aminophylline) may be given if symptoms are severe or persistent.

Lexi Stress Test Nuclear Imaging

The nuclear imaging component involves the injection of a small amount of radioactive tracer that circulates through the bloodstream and is taken up by healthy heart muscle. Areas with reduced blood flow appear as defects on the scan.

This technique allows physicians to detect blocked or narrowed coronary arteries, measure ejection fraction, and assess overall heart muscle viability. Images are captured in two phases: at rest and after Lexiscan-induced stress.

Modern systems use SPECT (single photon emission computed tomography) or PET (positron emission tomography) cameras for high-resolution imaging. Advanced software may also provide attenuation correction and 3D reconstruction.

Lexi Stress Test Heart Imaging Guide

Heart imaging with Lexiscan stress testing follows a structured protocol:

1. Patient Preparation: Confirm fasting, no caffeine, appropriate medication adjustments.
2. Rest Phase Imaging: Radioactive tracer injected; rest images taken.
3. Stress Induction: Lexiscan 0.4 mg IV bolus over 10 seconds, followed by saline flush and tracer injection.
4. Post-Stress Imaging: After appropriate circulation time, stress images are obtained.
5. Image Analysis: Cardiologist reviews perfusion patterns, ejection fraction, and wall motion abnormalities.

The results are interpreted alongside clinical history, ECG changes, and other diagnostic tests to provide a comprehensive cardiac assessment.