Part B Insider (Multispecialty) Coding Alert

Question: Why am I getting denials for radiopharmaceutical injection (79101) with MPI (CPT 78452 )?

Answer: These two codes are bundled, and you may not override the bundle.

Code 79101 (Radiopharmaceutical therapy, by intravenous administration) is appropriate for IV administration for radiopharmaceutical therapy.

You should not use it for a diagnostic test such as 78452 (Myocardial perfusion imaging, tomographic [SPECT] [including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed]; multiple studies, at rest and/or stress [exercise or pharmacologic] and/or redistribution and/or rest reinjection).

Don't forget: If your physician practice bears the cost of the radiopharmaceutical (RP) used for MPI, you should report the HCPCS code for the RP supply separately.