Cardiology Coding Alert

Question: A patient undergoes a dobutamine stress test (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). I know that 90780 (IV infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one hour) cannot be billed with 93015 and J1250 (injection, dobutamine HCI, per 250 mg), but can we bill for the normal saline and atropine used during the infusion? Our office is billing J1250 along with J7050 (infusion, normal saline solution, 250 cc) and J0460 (injection, atropine sulfate, up to 0.3 mg). Is this correct?

California subscriber

Answer: If the cardiologist performs the procedure in his or her office, all supplies used should be billed and reimbursed, says Terry Fletcher, BS, CPC, CCS-P, an independent coding and reimbursement specialist in Dana Point, Calif. As long as the cardiologist administers the supplies and pays for it, he or she can bill for it, she explains, noting that including an invoice with the claim may speed up payment for the medications.
If the procedure is performed in the hospital setting, however, supplies should not be billed because the hospital has paid for them and is reimbursed under Part A Medicare.