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2010 cpt code changes

  1. Default 2010 cpt code changes
    Exam Training Packages
    Looking over 2010 CPT guidelines. Looks like codes for nuclear studies: 78478, 78480 and 78465 have been deleted and replaced with new codes. Does anyone have any info on this??

  2. Default
    For FY 2010 they've created 4 new CPT codes for Myocardial Perfusion Imaging; 2 for tomographic SPECT (single & mult) and 2 for planar images (single & mult)

    They've included wall motion and ejection fraction when performed...so there's not separate coding for those as in the past...78478 & 78480

    78451 Myocard Perf imag Spect including wall motion & ejection fraction when performed...single study

    78452 mult. studies, rest and /or stress

    78453 Myocard Perf imag Planar inlc wall motion & ejection fraction when performed; single study

    78454 mult. studies, rest and/or stress

    Hope this helps,
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS
    ciphermed@optonline.net

  3. Default
    Thank you so much for the information!! You have been a great help to our office..

    pscanish

  4. #4
    Location
    Jefferson County Coders, Alabama
    Posts
    10
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    Does anyone have any idea of the pricing for Medicare yet?

    Rhonda

  5. #5
    Talking Suzanne
    I'm looking for the fee too!:

  6. Default
    CMS does have the 2010 National Physician Fee Schedule Relative Value File available and the Geographic Practice Cost Indices. I plugged in the numbers and came up with close to $280.00 reimbursement. I'm in Upstate NY. Not sure that I did it right though. That's a 50% reduction!! I must have done it wrong.

  7. Default Mrs. Hpav
    The 2010 National Physician Fee Schedule is now available online. The reimbursement for CPT code 78452 is $325.17. That is a 50% reduction.

  8. Default
    Right on with the codes, but when I have billed the insurances for the code 78452-26, they get denied, stating this is a global procedure, pay the hospital, and say that we cannot bill this with a 26 modifer attached Anyone else having a problem with this, or figured out the solution???????????

  9. #9
    Location
    Grand Canyon Coders
    Posts
    21
    Default
    Our billers are discovering that many of the commerical carriers are denying for the same reason. Medicare is paying for the procedure. As of now, we have not been able to get a straight answer from the insurances regarding this - no surprises there.

    Looking for an answer/solution as well.

    Jennifer CPC

  10. #10
    Default
    Quote Originally Posted by MACEY01 View Post
    Right on with the codes, but when I have billed the insurances for the code 78452-26, they get denied, stating this is a global procedure, pay the hospital, and say that we cannot bill this with a 26 modifer attached Anyone else having a problem with this, or figured out the solution???????????
    We are having the same problem here with one of our carriers. They are stating that we need to send them all the proper documentation and appeal it. However they are stating that there is no promise of payment.
    Jessica Chandler CPC, COC, CPC-P, CPB, CCC
    Charleston, WV

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