Wiki Nuclear Stress Test

[rcartwright]

I have a cardiologist that has a mobile unit that comes to his office to do nuclear stress tests. Medicare is denying the 78452-TC stating the cardiologist cannot bill for this because his clinic is not accredited.
Can anyone give me any help on this if there is any way we can bill for the technical component for this code?

 

[thomas7331]

If your cardiologist is paying this mobile unit to perform this test, then this is what is called a 'purchased' service. Medicare has special rules governing this type of arrangement (including anti-markup rules that limits on how much you can bill). I haven't personally billed these, so can't advise much beyond this, but perhaps other forum users will have more information. I'd recommend reviewing these rules and/or contact your region's Medicare contractor for more information if needed. Here's the page for Noridian's guidance on this which provides some links and might be a good starting point: https://med.noridianmedicare.com/we...ostic-tests-purchased-or-personally-performed

 

[rcartwright]

If your cardiologist is paying this mobile unit to perform this test, then this is what is called a 'purchased' service. Medicare has special rules governing this type of arrangement (including anti-markup rules that limits on how much you can bill). I haven't personally billed these, so can't advise much beyond this, but perhaps other forum users will have more information. I'd recommend reviewing these rules and/or contact your region's Medicare contractor for more information if needed. Here's the page for Noridian's guidance on this which provides some links and might be a good starting point: https://med.noridianmedicare.com/we...ostic-tests-purchased-or-personally-performed

Thanks!