Cardiology Coding Alert

Question: If the cardiologist uses 4.1 mCi of thallium, should I bill as 4 units or 5 units? An auditor has told us to bill at 5 units, but everyone else seems to bill this at 4 units. I have always gone by this rule: If the cardiologist uses 4.5 mCi, I would bill as 5; however, if he uses 4.4, then I would bill as 4. Is this true?

Wyoming Subscriber

Answer: You're right that you need to be cautious in how you report units of thallium (A9505, Thallium TI-201 thallous chloride, diagnostic, per millicurie), but you're mistaken in how you're reporting 4.4 units.

You should report what you use. In other words:

• if your cardiologist uses 4 millicuries, you should report A9505 x 4.

• if your cardiologist uses 4.4 millicuries, you should report A9505 x 5.

• if your cardiologist uses 4.5 millicuries, you should, again, report A9505 x 5.