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INCOMPLETE STRESS TEST DUE TO CLAUSTROPHOBIA

Kelly Posted Tue 05th of February, 2013 15:30:20 PM

DURING A NUCLEAR STRESS TEST THE PATIENT BECAME CLAUSTROPHOBIC AND NEEDED TO STOP. NORMALLY WE CHARGE '78452', '93015', 'A9500'X2. WE WERE ONLY ABLE TO INJECT THE PATIENT WITH ONE DOSE OF 'A9500'. AS WE STARTED THE RESTING PICTURES AT THE BEGINNNING OF THE TEST THE PATIENT ASKED TO BE REMOVED FROM THE CAMERA BED. ARE WE ABLE TO CHARGE ANYTHING FOR THIS TEST?

SuperCoder Answered Fri 08th of February, 2013 21:44:28 PM

There’s different advice on stopped services, but you want to be sure the payer understands something unusual happened and you’re being open with them about exactly what was performed. In general, you could report 78451 (since rest only) with mod 52 (payer may ask for documentation of what was performed, including A9500 admin to indicate procedure was started), A9500x1. It doesn’t appear anything related to 93015 was performed. Check to see if the payer has a specific mod 52 policy.

Slide 42 of http://www.swcsnm.org/meetings/2011Presentations/fridaypres/07_Merlino.pdf addresses a similar topic.

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