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Nuclear Stress Test-Help

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    Medical Coding Books
    ADENOSINE MYOCARDIAL PERFUSION STUDY
    CLINICAL INDICATION: 53-year-old patient with chest pain.
    TECHNIQUE: Adenosine 104 mg intravenously dual isotope separate acquisition
    gated myocardial perfusion SPECT using Tc 99m Sestamibi 42.8 mCi
    intravenously at stress and Thallium 201 4.0 mCi intravenously at rest was
    performed using the rest/stress sequences at stress. The SPECT images were
    obtained in the supine position only.
    FINDINGS: Perfusion images reveal no definite evidence of perfusion
    defects.
    Adenosine post stress gated SPECT images show no wall motion abnormalities.
    IMPRESSION:
    1. NO EVIDENCE OF PERFUSION DEFECTS OR WALL MOTION ABNORMALITIES.
    2. THE LEFT VENTRICLE EJECTION FRACTION AT STRESS IS 70%.
    A CALL REPORT WAS MADE TO DOCTOR AND A MESSAGE WITH THE RESULTS
    WAS LEFT ON 10/25/2010 11:40 AM.

    The above mentioned report was dictated by the NP for the adeno done in the hospital.


    The below mentioned report was by the Doctor


    CLINICAL INDICATION: Preoperative risk assessment hypertension,
    hyperlipoproteinemia, EKG abnormalities.
    PROCEDURE: Patient was attached to continuous EKG and blood pressure
    monitoring. Subsequently, a total of 104 mg of adenosine was infused
    over 5 minutes. This was followed by SPECT nuclear imaging.
    CLINICAL INFORMATION: Resting heart rate is 71, peak heart rate 83
    beats per minute.
    Resting blood pressure 127/74, peak blood pressure 154/67.
    CLINICAL SYMPTOMS: None.
    RESTING ELECTROCARDIOGRAM: Sinus rhythm, nonspecific ST-T changes,
    right bundle branch block.
    STRESS ELECTROCARDIOGRAM: No changes.
    SUMMARY: Clinical: Nonischemic.

    Now if someone can tell me how would the test be billed. If I bill the 93016, 93018 & 78452-26 then what will the NP bill for her portion?
    Last edited by peeya; 12-09-2010 at 02:42 PM.

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