Cardiology Coding Alert

Question: Which code should we use to bill for the pyrophosphate used during a multi-uptake gated acquisition (MUGA) scan?

Georgia Subscriber

Answer: Pyrophosphate is a tagging agent that is used with technetium when a MUGA scan is performed to measure the heart's wall motion. The pyrophosphate is part of a "kit" that also includes technetium. Typically, blood is pulled from the patient who will be scanned and is mixed with the pyrophosphate and the technetium, then reinjected into the patient.

There is no separate code for pyrophosphate, which is billed as a supply in conjunction with technetium. Because the kit consists of more than the radiopharmaceutical, HCPCS code A950x (Supply of radiopharmaceutical diagnostic imaging agent ) should not be used. The correct code for the kit is A4641 (Supply of radiopharmaceutical diagnostic imaging agent, not otherwise classified).

The answers to You Be the Coder and Reader Questions were provided by Gay Boughton-Barnes, CPC, MPC, CCS-P, chief medical compliance officer for the University of Oklahoma Medical Center in Tulsa; Sandy Fuller, CPC, a practice coder with Cardiology Consultants, an 11-physician practice in Abilene, Texas; Martha Gerant, CPC, a practice coder with Cardiology Services, an 11-physician practice in Shawnee Mission, Kan.; Linda Laghab, CPC, a practice coder with Pediatric Management Group, a multispecialty practice at Children's Hospital Los Angeles; Sandy Rubio, RN, CPC, a cardiology coding and reimbursement specialist in Omaha, Neb.; Rebecca Sanzone, CPC, billing manager with Mid-Atlantic Cardiology, a 45-physician practice in Baltimore; Nikki Vendegna, CPC, a cardiology coding and reimbursement specialist in Overland Park, Kan.; and Marko Yakovlevitch, MD, FACP, FACC, a cardiologist in private practice in Seattle.