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2 Day Nuclear Stress Tests

  1. #1
    Arrow 2 Day Nuclear Stress Tests
    Medical Coding Books
    I am coding 2 day nuclear stress tests and am not sure I am coding them correctly, can someone please help? I am using codes
    78452 - because 2 (stress and resting) tests are being done
    93015 - for the reading, supervision and testing
    A9500 2 units - it is injected after the stress test and then again on the 2nd day for the resting part

    Is this correct? Should I at any point be using A9505? I don't see that the drug is documented anywhere in the physician interpretation.

    If the patient does not have a treadmill stress test done but has a drug induced stress test, I am using code J2785 4 units for the Lexiscan that was injected.

    Are these the correct codes? Someone told me I should be using 78451 instead of 78452 but it looks like you only use that code if the patient has a stress test or a resting test, not both. Any thoughts? Help please!!
    Chrissy, CPC

  2. #2
    Alexandria, LA
    If they had both stress and rest + SPECT then 78452 is correct. If SPECT isn't mentioned, then 78454 instead.
    Is the stress test done on your own equipment (not at the hospital)? If so, and the same doctor supervises, interprets and reports then 93015 is correct.
    Use the A code for the radiopharm that you used. Did you do this with thallium or with sestamibi? Don't code A9505 if thallium wasn't used.
    Use J2785 if Lexiscan is given (or other codes if adenosine, persantine, etc are used.)

  3. #3
    Phoenix, AZ
    Yes, you are correct. If you don't see Thallium anywhere on the report, I would not code it. Make sure your MD is dictating how much Lexi is used.

    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  4. #4
    Thanks so much! This was my first time coding these and it looks like they have not been coded correctly in the past. I was unable to find a code for Adenosine. I used A9270 because the J-codes for Adenosine didn't seem to fit the scenario for the stress test. What do you use for Adenosine? I only had one case that the drug was used so it doesn't look like I will see it often. Thanks again for your responses!!
    Chrissy, CPC

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