nuclear stress test

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Our biller has been billing 78478 x2 & 78480 x 2 for the adenosine injection. We have been getting paid once for each code. The reason for the denial is one servie per day. Since the test is done resting and stress and the adenosine is done twice is there a better way of billing, so we don't get denied?
My concern is that neither of these codes represents the Adenosine and neither represents injection.

These add on codes describe specific, additional evaluation (78478, Wall Motion Study & 78480 ejection fraction) beyond the perfusion scan itself (housed elsewhere in the code section). Adenosine should be represented in HCPCs and the injections are inherent to the performance of the service/scan/study.

I hope this answers your question.

Good luck.
78478 and 78480 should be coded once. Try J0152 for the adenosine. This code is for 30 mg so you will probably have to use 2-3 units depending on how much is used.