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NUCLEAR STRESS TESTS WITHOUT IMAGES

Lawrence Posted Tue 09th of July, 2013 16:30:42 PM

MY PHYSICIAN GOES TO A SMALL HOSPITAL ON FRIDAYS AND DOES NUCLEAR STRESS TESTS WITH NO IMAGING. HE SAYS THEY DONT EVEN WALK ON THE TREADMILL, SOME ARE LEXISCANS AND SOME ARE JUST REGULAR NUKES,. how do i code these?

SuperCoder Answered Wed 10th of July, 2013 12:12:37 PM

The mention of “no imaging” sounds like a pharmacologic stress test with codes 93016 (assuming supervision) and 93018 (interpretation and report) since it’s a facility setting. But a nuclear stress test essentially means an RP is injected as part of imaging, so the mention of “no imaging” is confusing. Will you please clarify?

Lawrence Posted Wed 10th of July, 2013 13:14:13 PM

ON HIS HOSPITAL CHARGE SHEETS,HE HAS "lEXISCAN "NO IMAGES", ADENOSINE "NO IMAGES". I ASKED HIM IF THE PATIENTS GOT ON THE TREADMILL AND HE SAYS "NO, I AM ONLY GETTING PAID FOR THE TEST NO IMAGES. i AM CONFUSED. PLEASE ANSWER ASAP.

THANKS,

KAREN P.
OR YOU CAN CALL ME AT 904-399-4122
THANKS AGAIN

Lawrence Posted Thu 11th of July, 2013 14:08:24 PM

In his report, it says that the pt was infused with 40 of cardiolite intravensouly and then less than 1 hour later 0.4mg of lexiscan . images will be reviewed by another physician.

SuperCoder Answered Thu 11th of July, 2013 15:07:40 PM

The Lexiscan and adenosine are used to stress the heart for patients unable to perform treadmill/exercise. It sounds like this is a pharmacologic stress test. So you have 93016 for supervision and 93018 for interpretation and report, assuming those services were provided. Presumably someone else is performing/billing for the imaging portion of the nuclear study.

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