Cardiology Coding Alert

Question: We sometimes use a two-day protocol for resting and stress SPECT scans. Should I report separate dates of service?

Georgia Subscriber

Answer: When your cardiologist performs the rest or stress portion of the SPECT scan on two different days, you should report the test either on the first or second day, listing all relevant codes, which may include:

Imaging: 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

Stress test (choose one): 93015-93018, Cardiovascular stress test …

Radiopharmaceuticals/stress agents.

While logic may recommend that you choose the second day as the DOS, some carriers want you to report the codes using the first day as the DOS. Check with your carriers to see which day they prefer. Note that hospitals may have to follow different rules for reporting.

Final tip: If you’re reporting the cardiologist’s role in a facility-based (not office-based) test, append modifier 26 (Professional component) to 78452.