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Nuclear stress coding

  1. Default Nuclear stress coding
    Medical Coding Books
    Our practice was recently acquired by an area hospital. We have three cardiologists, one with a subspecialty certification in nuclear cardiology, who reads/reports all tests. Previously, as an equal partnership sharing, each MD billed the global fees (78452/93015/A9500 x2) although the Nuclear cardiologist reads and interprets the nuclear scans, co-signed by the attending.

    Now we are being told to bill as follows: Drs A & B are NOT board certified in nuclear cardiology - Dr. N is.

    If Drs A or B do a nuclear stress test, they are to bill 93016 only.
    Dr. N is to bill 78452, 93018 and A9500 x2, even though he is not physically present for any of the testing, is reading the SPECT images later in the day and rendering a report on the SPECT images only, not the stress portion of the test.

    Our coder feels that the correct coding should be:
    Drs A/B: 78452-TC, 93015, A9500 x2
    Dr. N: 78452-26

    What's correct?
    Last edited by am1230; 02-08-2011 at 12:23 PM.

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