by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
Myocardial SPECT Multiple Studies w Cardiovascular Stress Test
Question:
For the above tests, the supervising provider listed in the report is the Physician Assistant. The interpretation is done by the physician. The codes billed are 78452 MC, 26 and 93018. If the physician is only billing for the interpretation of the stress test, do we add a -52 to the 78452 for the interpretation of the myocardial spect studies for the physician? The physician is just interpreting that portion of the test as well?
Answer:
I will assume that this was performed in a hospital setting. When a physician performs the interpretation of any radiologic service, since they did not employ the hospital staff or own the hospital equipment, they will bill for the interpretation of the imaging study (i.e., the reading of the exam). The way they identify this on a claim is by assigning the CPT code for the service rendered (here 78452) with the modifier -26.
You might find these of interest…
Complete Interventional Radiology and Cardiovascular Coding
From ZHealth Publishing, the experts in coding of IR/CV procedures.
Detailed information on a broad range of Interventional Radiology and Cardiovascular procedures and the guidelines for proper coding.
41 AAPC CEUs! Learn more
IR/CV Medical Coding Seminar
VIRTUAL + LIVE Las Vegas, NV December 4-8, 2023
Earn up to 27.5 AAPC CEUs, 31.5 ASRT CEUs, and/or 27.5 AHIMA CEUs.
Learn more
