Cardiology Coding Alert

Question: Our physician interpreted a cardiolite stress test done at the hospital. He did not perform the test but interpreted the nuclear images. The operative note indicates that the test included resting images only, and there was no gating. How should we code this?

Virginia Subscriber

Answer: You should report 78464 (Myocardial perfusion imaging; tomographic [SPECT], single study, at rest or stress [exercise and/or pharmacologic], with or without quantification) for the nuclear study and append modifier 26 (Professional component) for your physician's interpretation. The hospital will bill for the technical component. No gating means that the physician did not take wall motion or ejection fraction measurements.

Also, if the physician provides only the official stress test interpretation, use 93018 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only).

-- You Be the Coder and Reader Questions were prepared with the assistance of Jim Collins, ACS-CA, CHCC, CPC, CEO of the Cardiology Coalition and compliance manager for several cardiology groups around the country; and reviewed by Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in N.C.