Nuclear Medicine Question for the Week of January 30, 2017

Question:

Question:

I have been getting a correct coding initiative (CCI) edit when I bill the following on the same date of service (DOS): 78815 with A9552 and code 78306 with A9503.

78815 Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh
A9552 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries
78306 Bone and/or joint imaging; whole body
A9503 Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries

The A codes are triggering correct coding initiative (CCI) edits with the opposing imaging services. Am I billing incorrectly?

Answer:

Answer:

You are billing the correct codes. If this is for a Medicare patient and you are billing for the hospital, leave one of the radiopharmaceutical HCPCS codes off the claim (since there is no separate payment anyway). If the patient is not Medicare, then check your payers’ policies to see if they use Medicare edits.