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Radiology Coding Alert

READER QUESTIONS:

Tackle 78007 Units for Multiple Days

Published on Sat May 09, 2009

Question: How should I code both days of the following nuclear medicine thyroid imaging/uptake scenario?

Scenario: Patient presents to our office at 9 a.m. for a dose of I-123. Patient returns four hours later for an uptake. Patient returns 24 hours later (9 a.m., day 2) for the uptake.

Tennessee Subscriber

Answer: You should report one unit of 78007 (Thyroid imaging, with uptake; multiple determinations) to cover the services for both days.

Date of service: If your payer offers a policy in writing stating which date to use as the date of service, follow that instruction.

If your payer doesn't offer a policy, the Society of Nuclear Medicine (SNM) suggests that you "establish one standard policy for billing and handle ALL procedure billing in that manner" in its Practice Management Coding Corner Q&A "Nuclear Medicine Dates of Service," created Aug. 5, 2008 (http://interactive.snm.org/index.cfm?PageID=7870&RPID=1995).

The Q&A focuses on a scenario in which a hospital performs imaging and radiopharmaceutical (RP) admin on day one and thyroid uptake scan on day two.

If you foot the bill for the RP, SNM recommends that you always bill the RP on the day you administer it. But "the radiopharmaceutical and the procedure should always be on the same claim, even if performed on separate days," SNM states.

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