Cardiology Coding Alert

Question: For performing a Thallium stress test (the treadmill portion would be in our office and the Thallium would be administered in the hospital, adjacent to our suite), I need to know what radiology code I would bill in addition to the 93015-93059 for the treadmill portion of the stress.

Anonymous Indiana Subscriber

Answer: The Thallium test should be billed using 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report), Terry Fletcher, MBA, CPC, CCS-P, president of Physician Reimbursement Solutions, a coding and reimbursement firm in Laguna Beach, CA, says. The correct imaging codes are 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) with a -26 modifier (professional component). In addition, code 78990-26 (provision of diagnostic radiopharmaceuticals) should be billed, because the hospital bills for the 78990's technical component, Fletcher says, adding that if you have problems getting paid for treadmills at the same time as the thallium test, add a -59 (distinct procedural service) to the treadmill.