Wiki Coding Myocardial Perfusion Imaging (MPI) Studies

[smerriweather1]

Hello,

I hope someone can assist me with this coding issue.

I am coding for the Cardiologist's professional portion only, I am not responsible for the facility side. Our provider performs the interpretation and supplies a report for the Cardiovascular Stress Testing portion (CPT 93015-93018) of the MPI while the a radiologist provides the report for the imaging portion of the MPI Planar studies (78453-78454). Am I correct to only be coding the 93015-93018 for the cardiologist? Another coder in my group thinks I should be coding 78453,26 but I disagree because the report completed by the cardiologist only addresses the stress test component and does not make mention of any pharmacological agents, dosing of medication, etc...

Any thoughts are greatly appreciated.

Sandy M

 

[smerriweather1]

An example of the docuemntation I am working with

If it helps here is a sample of what I am working with:

Informed consent was obtained. The patient underwent pharmacologic testing with adenosine. A total of 48.4 mg adenosine was used in this study. Resting ECG showed a sinus mechanism with anterior wall myocardial infarction and T-wave abnormalities. The study was technically difficult. Occasional, isolated PVCs were noted on this study. No noteworthy changes were noted on the pharmacologic stress. The patient did have ventricular ectopy and a rare PAC present apparently. The patient was hypertensive at times. Oxygen saturations were 93%-98%.

IMPRESSION:
1. Abnormal resting ECG (see above) with dysrhythmias during the monitoring session.
2. The patient completed a standard protocol for adenosine nuclear study.
3. Correlate clinically (and with nuclear images).

 

[cardione]

If the only thing they're reviewing is the EKGs then that's all they can bill for. The fact than an imaging study was also done doesn't mean they can bill for it as well. Both of these tests can be done stand-alone. I have a provider who routinely does the interpretation just for the nuclear imaging with a note that "stress EKG will be interpreted separately"

Jasmin CCC, CRC