Cardiology Coding Alert

Question: Our practice is going to start providing thallium stress tests in the office. I was told that I can bill for end systolic and diastolic volume if specified on the test. I was under the impression that I could bill only for SPECT, gated wall and ejection fraction. Which is correct? Mississippi Subscriber

Answer: You are correct. There is no billing for end systolic and diastolic volume with a nuclear stress test. You can only bill for the SPECT (78465, Myocardial perfusion imaging; tomographic [SPECT], multiple studies, at rest and/or stress [exercise and/or pharmacologic] and redistribution and/or rest injection, with or without quantification), the wall motion (+78478, Myocardial perfusion study with wall motion, qualitative or quantitative study) and the ejection fraction (+78480, Myocardial perfusion study with ejection fraction). Answers for You Be the Coder and Reader Questions were provided by Nikki Vendegna, CPC, a cardiology coding and reimbursement specialist in Overland Park, Kan.; Marko Yakovlevitch, MD, FACP, FACC, a cardiologist in private practice in Seattle; Lisa Clifford, CPC, owner of the multispecialty coding firm Clifford Medical Billing Specialists Inc. in Naples, Fla.; Jim Collins, CHCC, CPC, a coding consultant and compliance officer with Mid-Carolina Cardiology in Matthews, N.C.; Sandy Fuller, CPC, a cardiology coding and reimbursement specialist in Abilene, Texas; and Sheldrian Wayne, CPC, a cardiology coding specialist with Atlanta-based Coding Strategies Inc.