Nuclear Medicine Question for the Week of September 12, 2016

Question:

Question:

A patient pulled himself out of the scanner after receiving the pharmacologic stress agent injection, and the stress imaging portion of the cardiac positron emission tomography (PET) myocardial perfusion imaging (MPI) rest / stress study could not be completed. How do we bill for this procedure? Do we bill for the completed rest study as a single study only (78491) and document in the report that the stress portion of the study could not be done, or do we append a modifier to the uncompleted study (78492)?

Answer:

Answer:

There are two answers, which depend on whether you are asking in regard to the physician or the facility.

For outpatient hospital billing, the facility could bill 78492-52, since the radiopharmaceutical for the stress portion had been given. The facility could choose to assign only 78491, but 78492-52 would be acceptable.

78491 Myocardial imaging, PET, perfusion; single study at rest or stress
78492 Myocardial imaging, PET, perfusion; multiple studies at rest and/or stress

For the physician interpreting the exam, report only 78491-26, for the portion of the exam that was completed.