Cardiology Question for the Week of May 6, 2019

Cardiology Compliance Question of the Week

Question:

We have a new facility that performs a two-day thallium viability scan. It is assigning codes 78451 and 78452 for this exam. Is this correct?

Answer:

Not exactly. This would be reported either as 78452 or 78454 and whichever code is used, it would be billed only once. The choice of codes reported depends on whether single-photon emission computerized tomography (SPECT) is performed (78452) or not (78454). These codes are multiple exam codes and frequently take place over multiple days. If multiple studies such as stress and rest, or rest and redistribution are performed, then the most appropriate code is reported once for the entire process. You do not report separate codes for each day.

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
78454 Myocardial perfusion imaging, planar (including 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 reinjections

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