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Cardiology-nuclear stress test

  1. #1
    Default Cardiology-nuclear stress test
    Medical Coding Books
    Can anyone give me some information on which modifier should be billed with the A9500 on the second part of the nuclear stress test, is it 59 or 25?

    Thanks in advance

  2. Default
    How are you billing A9500 during a nuc study? A modifier is not required for A9500.

  3. #3
    Default Cardiology
    United Healthcare are denying the second part of the nuclear test which is done on a separate day.

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    is it the A9500 that they want a modifier on or the actual procedure? Neither 25 or 59 would be appropriate on this code (and as stated before should not need any modifier), which makes me wonder about the code in denial.
    Lisa Bledsoe, CPC, CPMA

  5. #5
    Default
    Yes, I was told that on the second part (A9500) it requires a 25 or 59 modifier.

  6. #6
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    it can't be 25 since that is only applied to e/m codes.
    Lisa Bledsoe, CPC, CPMA

  7. #7
    Location
    St. Louis East
    Posts
    17
    Default
    No modifier is needed. I have been having problems with United Healthare denying A9500 and A9700. They have a contrast material policy on their website, www.unitedhealthcareonline.com. It has a list of the CPT codes that have to be billed with the contrast material. They are my least favorite insurance, because a lot of their denials don't make sense, and most of the reps I speak with don't understand what we are talking about.
    Good Luck!

    Nikki

  8. Default
    I'm guessing you may not be billing the nuclear study correctly this is the reason for having your injections denied. To bill the nuclear study you do not need to bill for both dates. We never had problems with United Healthcare denying payments. You should also submit the NDC number and copy of the drug invoice with the claim.

    Dolores, CPC, CCC

  9. #9
    Default
    Thanks for the information.

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