Wiki 78452, stress test

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MFaulkner

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Can someone please help, I have been trying to figure out what the code that replaced 78452 in the nuclear stress test is for medicare and medicaid. normally we charge 93015 and 78452 however were informed that that is no longer valaid for mcr and mcd therefore have started using 93016, 93018 and am not just what to use in place of 78452 everything we have tried hasn't worked. any information would be greatly appreciated:confused:
 
It is my understanding that when 78452 became the new code it replaced using 78465, 93015, 78478, 78480. We no longer bill the 93015 with the 78452 because it is now considered included in the main code.
 
Are you billing for technical, professional or global services? We bill 78452, 93015 + meds when done in house. You have to use a -25 modifier on your E&M if done same day. If test done at hospital we bill 78452-26, 93016 and 93018.
 
I don't know what I was thinking. In office, we do bill Medicare the 93015 with 78452 global charge and are getting paid on it. The office visit will get denied as now if you do not put a mod 25 on it.
 
i was talking about in hospital mostly, we also do them in office but are not having problems there just the hospial and we were told by mcr that they were no longer accepting the 78452 so i am confused
 
i called and they stated that the denial is coming from my local and that they couldn't see a reason why but that they couldn't do anything about it I would have to contract my local and I can't get them to give me a direct answer
 
78452.26 and 93016 inclusive

:confused:We billed 99291, 93016, 93018 and 78452.26. We have been paid on everythign except the 78452.26 stating it is inclusive to 93016. Should we have attached modifier 25 to 99291 or 93016 states that 78452 is included in the service... please help me.

Confused
 
78452 and 93016 should be allowed. If your Medicare payer is denying - then appeal. Use the instructions in the CPT book (look at the guidelines before 78414 - where it tells you to use both code/s from 93015-93018 and 78451-78454. My guess is that they have a glitch in their system and until someone appeals high enough they won't fix it. You may have to go through the first couple of levels of appeals.
 
I too not sure about it, when I submitt 78452-26, and 93015-59---medicare is paying only for 78452-26.
 
MFaulkner said:
Can someone please help, I have been trying to figure out what the code that replaced 78452 in the nuclear stress test is for medicare and medicaid. normally we charge 93015 and 78452 however were informed that that is no longer valaid for mcr and mcd therefore have started using 93016, 93018 and am not just what to use in place of 78452 everything we have tried hasn't worked. any information would be greatly appreciated:confused:
Click to expand...

amym said:
We get paid by Medicare for CPT 78452-26 just fine. Anyone else having issues?
Click to expand...

if Dr does in clinic-78452-26 &93015-59, and if he does in out pt-hospital(POS-22) can you tell me what do you code. Do you code the same why because out-pt hospital is ambulatory soo.
 
Code 78451 or 78452

We are doing Myocardial perfusion at rest and with ecercise with our equiment in the physician office. My concern is that one physician is doing the interpretation and another physician is supervising the exercise test. It would be appropriate to code 1st physician , 78452 , 93018 and 2nd physician 93016 ?. Thank you.
 
We billed in office nuclear testing with 78452 and 93015 with a 51 modifier. Has anyone else done this? We have not had any issue getting paid for both.
 
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