Wiki Myocardial perfusion study

[Pwalden729]

Clarification needed. Pt undergoes the above but subsequent to first scan MD determines resting images are not required, should code 78452 or 78451 be used? There is some problem occurring in our office regarding authorization for these codes with 78452 being authorized and approved and then MD does not obtain resting images (initial images normal). Denial is received if we code 78451 as it was not auth. Better to code 78452 with modifier for reduced services and let carrier pay accordingly?

 

[micalbee65]

We do these at our sites and the code 78451 is for a single study, be it rest or stress. It would not be appropriate to bill the 78452 with a 52 because there is a code that already describes what is being done. Try and have the auth changed to reflect the correct study that was performed.