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Billilng 78802 and 78815

  1. #1
    Question Billilng 78802 and 78815
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    Is it customary and/or appropriate to bill 78802 and 78815 for the same patient during the same encounter, same date of service without billing A codes for the radiopharmaceuticals? Is the FDG an appropriate radiopharmaceutical for both procedure? What pieces of documentation should be submitted to Medicare to support both of these codes? Are there separate and different hard copy output results for each of these diagnostics? Thanks.

  2. #2
    Default Billilng 78802 and 78815
    According to Code Correct "Under OPPS, nuclear medicine procedure code 78815 maps to a radiolabeled product-dependent APC. Claims for this procedure must include at least one required radiolabeled product * to pass Medicare payer edits."
    I'm not sure about your other inquiries, hopefully someone else can answer.
    S. Michelle Waters, CPC

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