Oncology & Hematology Coding Alert

Question: How should we bill for multiple thallium studies with multiple-gated acquisition (MUGA) scans?

Colorado Subscriber Answer: For the thallium, use 78461 (Myocardial perfusion imaging; multiple studies, [planar] at rest and/or stress [exercise and/or pharmacologic], and redistribution and/or rest injection, with or without quantification). For MUGA, use 78473 (Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress [exercise and/or pharmacologic], with or without additional quantification).

You may be tempted to report +78478 (Myocardial perfusion study with wall motion, qualitative or quantitative study [list separately in addition to code for primary procedure]) or +78480 (Myocardial perfusion study with ejection fraction [list separately in addition to code for primary procedure]) along with 78461, to receive payment for the wall motion and ejection fraction. MUGA studies, however, include both wall motion and ejection fraction.