E&M same day as Nuclear Stress Test

JBurnham

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We perform Nuclear Stress Testing in our office. Our physicians have recently been told by a colleague that if the patient being referred to them is new to the practice and they perform a brief consult or history and physical, they can also bill this in addition to the test.

I have always been under the impression that the "brief H&P" would already be included with part of the test and you would not bill this separately.

I have been able to find no guidelines on this. The only reasoning I can find for them to do this is if the referring doctor specifically requests for the doctor to also do a consult in addition to the test. Otherwise, I cannot see billing an E&M with this.

Does anyone currently do this or have you heard of doing this?
 

cfuficat

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Stress Test w/ EM

I also code stress tests but do not code an EM visit. Normally, the chief complaint is documented and a brief history which would be included in the test. I cannot find any specific guidlines on this either.

The patient being referred for the stress test already has some type of sign or symptom or established diagnosis. I do not see why it would be necessary for the physician to do their own E/M if it was not requested in a consult.

The only thing I could find in the CPT book is "If the physician provding nuclear medicine services is also responsible for the diagnositic work-up and/or follow-up care of the patient, E/M service codes should be coded in addition to the nuclear medicine procedures." I can see if the patients primary care requests a cardiology consult and the cardiologist decides to order/perform the stress test the same day but otherwise I don't think an E/M visit should be coded just because the patient is new.

Thanks,

Christy
 
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