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Outpatient FAQ March 2011: Myocardial Perfusion Studies on Multiple Days

Published on 

Tuesday, February 15, 2011

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Question:
What is the correct way to bill for myocardial perfusion studies that are performed over multiple days, for example the resting portion of the study is done one day and the stress portion is performed the next day?

Answer:
Even if performed on two separate dates of service, MMP, Inc. recommends billing only CPT code 78452 or CPT code 78454 (with a quantity of 1) representing myocardial perfusion imaging “multiple studies”, at rest and/or stress and/or redistribution and/or rest injection.

Do not use the single study CPT codes 78451 or 78453 (even with a reduced service modifier) to charge separately for each day. This would be considered unbundling.

References to support this recommendation include:

  • Society of Nuclear Medicine and MedLearn, Nuclear Medicine & PET Coder, 2010, page 87; and
  • Dr. Z, Diagnostic & Interventional Cardiovascular Coding Reference, 2011, page 484, coding instruction #5.
Article Author:

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.