You Be the Coder:
How to Report What the Cardiologist Uses
Published on Mon Jul 28, 2008
Question: If the cardiologist uses 4.1 mCi of thallium, should I bill as 4 units or 5 units? An auditor has told us to bill at 5 units, but everyone else seems to bill this at 4 units. I have always gone by this rule: If the cardiologist uses 4.5 mCi, I would bill as 5; however, if he uses 4.4, then I would bill as 4. Is this true?Wyoming SubscriberAnswer: You're right that you need to be cautious in how you report units of thallium (A9505, Thallium TI-201 thallous chloride, diagnostic, per millicurie), but you're mistaken in how you're reporting 4.4 units.You should report what you use. In other words:• if your cardiologist uses 4 millicuries, you should report A9505 x 4.• if your cardiologist uses 4.4 millicuries, you should report A9505 x 5.• if your cardiologist uses 4.5 millicuries, you should, again, report A9505 x 5.