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Cardiology Coding Alert

You Be the Coder:

What Date to Use for Stress Tests

Published on Sun Jan 01, 2006

Question: When I'm billing a two-day myocardial perfusion imaging test, should I use the last date as the billing date?


New York Subscriber


Answer: You should report this service using the myocardial perfusion imaging code 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). This code accurately represents both one- and two-day testing protocols.
 
You'll find variation as to what date you should use. Many carriers say use day 1 as the date of service. Others say day 2 to show the date when the cardiologist actually completed the service represented by the code.

Because conflicting policies existed among several Medicare carriers, the Society for Nuclear Medicine wrote to HCFA and received this reply in February 1999:

"The Medicare Carriers Manual, Part B, Section 2005, specifies that expenses for items and services other than expenses for surgery and childbirth are considered to have been incurred on the date the beneficiary received the item or service. When we apply this manual provision to the circumstances described in your letter relating to services that cannot be completed in a single day, a test that is reported using only one code and is conducted over more than one day would be billed showing the date the test was completed."

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