Cardiology Coding Alert

Nuclear Stress Test Coding Checklist

PLEASE NOTE - Some of the codes suggested in the article below (in the white area) are deleted since it was written. Here's the latest from Codify's Cardiology Coder:   Q: What Might a Sample Nuclear Stress Test Claim Look Like?
When your cardiologist performs a nuclear stress test for a patient, you need to report codes for more than just the RP.
Consider the following example: Suppose your practice performs a global stress test with both rest and stress phases and SPECT myocardial perfusion imaging for both phases. The providers dminister 0.4 mg of Lexiscan as the stress agent and a total of 41 mCi of Myoview as the RP. Summit Cardiology Business Office in Seattle calls this a "Lexiscan Nuc,"

says Janet Gordon-Thatcher, senior bookkeeper of patient accounts for the practice.

Solution: For the global stress test, report 93015 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report) , says Gordon-Thatcher. You'll also report...
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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 [...]
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