Query on 78452

prabha

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Please review the below report and confirm me whether we can code CPT 78452 & 75771 together?CPT 75571 is getting denied by Medicare stating “Routine and Screening services not covered”.Please provide me any guidlines for using this CPT.


TECHNIQUE: Following the intravenous administration of 3.3 mCi of
Technetium-99m sestamibi with the patient at rest, tomographic
images of the heart were performed. Subsequently during peak
treadmill exercise, the patient received a additional intravenous
dose of 26.1 mCi of Technetium-99m sestamibi, and additional
tomographic images were performed. The patient achieved a peak
heart rate of 146 beats per minute (87% of maximal predicted heart
rate) and a maximal blood pressure of 140/80 mm Hg. The patient
experienced no chest pain, and there were no ST segment changes
during exercise.

FINDINGS:
In both the stress and rest tomographic images tracer distribution
is homogeneous and physiologic throughout the entire left
ventricular myocardium.

Gated tomographic images with the patient at rest demonstrate
normal left ventricular wall motion and wall thickening. Left
ventricular ejection fraction is 53 %. End systolic and end
diastolic volumes are normal.

CT CORONARY ARTERIES:

Calcium scoring:

LM: 76
LAD: 12
CFX: 0
RCA: 0
Total calcium score = 88

IMPRESSION:

Normal study.

1. There is no scan evidence of exercise induced myocardial
ischemia.

2. Left ventricular systolic function at rest is normal with LVEF
of 53%. End systolic and end diastolic volumes are normal.

3. Coronary calcium score of 88 implies definite, at least mild
atherosclerotic plaque formation with a likelihood of mild or
minimal coronary artery narrowing.

4. The combined myocardial perfusion scan and coronary calcium
score findings are consistent with at least mild atherosclerotic
plaque formation in the left main and left anterior descending
arteries which is not hemodynamically significant.
 
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Check with medicare for your state, it may be that these two exams can not be on the same date and for the same reason, such as MRI & MRA brain here in ND. Also check for any LCD's for your area for these procedures because the diagnosis may not be coverable
 

chembree

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