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Nuclear medicine - SPECT scan

  1. Default Nuclear medicine - SPECT scan
    Medical Coding Books

    I have the above set of codes for the following procedure.But CPT 0147T is often getting denied and the rest are paid.Can we code this with


    HISTORY: Abnormal ECG

    Nuclear Imaging:
    Following the intravenous administration of 7.3 mCi of
    Technetium-99m sestamibi with the patient at rest, tomographic
    images of the heart were obtained. Subsequently during peak
    treadmill exercise, the patient received an additional intravenous
    dose of 21.7 mCi of Technetium-99m sestamibi, and additional
    tomographic images were performed. The patient achieved a peak
    heart rate of 157 beats per minute which is 96% of predicted
    maximum heart rate and a maximal blood pressure of 170/90 mm Hg.
    The patient experienced no chest pain, and no ST segment changes
    were noted in EKG.

    Cardiac CT:
    In addition, contiguous axial images of the heart were obtained on
    a multidetector CT with suspended respiration. Images were
    transferred to a Vitrea workstation for display and quantification
    of coronary artery calcification.

    Nuclear Scan:
    No fixed or reversible defects are apparent.
    Gated tomographic images show no left ventricular wall motion
    abnormalities with a left ventricular ejection fraction of 53%.

    Calcium scoring:

    LM: 0
    LAD: 0
    CFX: 0
    RCA: 0
    Total calcium score = 0

    1. Normal resting and exercise SPECT sestamibi myocardial
    perfusion examination.

    2. Coronary calcium score of 0 is consistent with no identifiable
    plaque with a very low risk of coronary artery disease.

    3. The combined nuclear and CT findings are consistent with very
    low risk of coronary artery disease and no hemodynamically
    significant coronary stenosis.
    Prabha CPC

  2. Default
    I am getting denials on 0144T and 0147T
    when billed with 78465, 78478, 78480

    I dont no should we need to add 26 modifier with T codes

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