Wiki 2010 cpt code changes

[pscanish]

Looking over 2010 CPT guidelines. Looks like codes for nuclear studies: 78478, 78480 and 78465 have been deleted and replaced with new codes. Does anyone have any info on this??

 

[ciphermed]

For FY 2010 they've created 4 new CPT codes for Myocardial Perfusion Imaging; 2 for tomographic SPECT (single & mult) and 2 for planar images (single & mult)

They've included wall motion and ejection fraction when performed...so there's not separate coding for those as in the past...78478 & 78480

78451 Myocard Perf imag Spect including wall motion & ejection fraction when performed...single study

78452 mult. studies, rest and /or stress

78453 Myocard Perf imag Planar inlc wall motion & ejection fraction when performed; single study

78454 mult. studies, rest and/or stress

Hope this helps,

 

[pscanish]

Thank you so much for the information!! You have been a great help to our office..

pscanish

 

[rcosta]

Does anyone have any idea of the pricing for Medicare yet?

Rhonda

 

[01029287]

Suzanne

I'm looking for the fee too!:

 

[cvand1972]

CMS does have the 2010 National Physician Fee Schedule Relative Value File available and the Geographic Practice Cost Indices. I plugged in the numbers and came up with close to $280.00 reimbursement. I'm in Upstate NY. Not sure that I did it right though. That's a 50% reduction!! I must have done it wrong.

 

[hpav]

Mrs. Hpav

The 2010 National Physician Fee Schedule is now available online. The reimbursement for CPT code 78452 is $325.17. That is a 50% reduction.

 

[MACEY01]

Right on with the codes, but when I have billed the insurances for the code 78452-26, they get denied, stating this is a global procedure, pay the hospital, and say that we cannot bill this with a 26 modifer attached Anyone else having a problem with this, or figured out the solution???????????

 

[coder16]

Our billers are discovering that many of the commerical carriers are denying for the same reason. Medicare is paying for the procedure. As of now, we have not been able to get a straight answer from the insurances regarding this - no surprises there.

Looking for an answer/solution as well.

Jennifer CPC

 

[jessica1974]

Right on with the codes, but when I have billed the insurances for the code 78452-26, they get denied, stating this is a global procedure, pay the hospital, and say that we cannot bill this with a 26 modifer attached Anyone else having a problem with this, or figured out the solution???????????

We are having the same problem here with one of our carriers. They are stating that we need to send them all the proper documentation and appeal it. However they are stating that there is no promise of payment.