Cardiology Coding Alert

The typical nuclear stress test has six separate, reimbursable charges, but do you know what they are? The following summary provided by coding experts will help you keep track of the top-six nuclear stress test coding components:

1. Report 78465 for multiple nuclear scans.Remember: Code 78465 covers both rest and stress scans, even if the cardiologist performed the scan on two separate days. If you dont own the scanning equipment, append modifier -26.
If the cardiologist performs only a rest or stress scan (single study), you should use code 78464 for the single study scan.
2.Add 78478 when the nuclear scan is a gated study in which the cardiologist performs a wall motion evaluation. Remember: Code 78478 is an add-on code and cannot be reported without a myocardial perfusion study code such as 78465 or 78464.
3.Add 78480 when the nuclear scan is a gated study in which the cardiologist measures the hearts ejection fraction. Like 78478, 78480 is an add-on code and cannot be reported without a myocardial perfusion study code such as 78465 or 78464.
4. Report 93015 for the stress portion of the study.Remember: You can use this code for both exercise-induced stress (patient uses a treadmill or bicycle) and drug-induced stress (patient has stressing agent injection). CPT 93015 includes electrocardiogram (EKG) monitoring supervision and reporting so you would not bill these components separately.
If the physician supervises the study but does not interpret it report 93016. If the physician performs interpretation and report without supervising the study report 93018.
5.Report the radioisotopes appropriate supply and dosage code. For example if the patient received sestamibi during both the rest and stress scans you would report A9500 x 2 doses.
6.Use the stressing agents appropriate supply and dose code. Remember: Pay attention to stressing agent dosage because you may need to report this in multiples. (See main article for details).