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Thread: MUGA Coding

  1. #1

    Default MUGA Coding

    AAPC: Back to School
    We billed a 78472 and it was rejected by Medicare stating the place of service did match. POS billed as 11 (extension of physician practice).
    Encoder Pro indicates 78472 needs to be billed with a stress test code also. Does anyone have insight into what I am doing wrong?

  2. #2

    Default Cpc

    Are you billing for the professional or technical component? If you are billing for the professional component, where was the study performed as an outpatient hosptial 22, or inpatient hosptial 21, independent clinic 49 (see page 2 of CPT to determine the place of service. Was this single study a rest or stress? If it was a stress test, and you are billing the physician whom read the continuous EKG see code 93018, if you are billing for the facility see code 93016, if the procedure was performed in a free standing clinic and you provided both portions of the procedure, see code 93015. Was a right sided ejection fraction done see code 78496. If you are billing for the facitliy, see the level II series HCPCs codes ie. Technetium A9538 or A9560.
    Last edited by rmickelson; 05-19-2009 at 04:54 PM.

  3. #3


    We bill as an extension of the physician's practice and that is why we bill the 11. This space is leased by the physician and is located across the hall in the same professional building. We are billing for the technical component only as well as the medications.
    Thanks for your response.

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