Forum - Questions & Answers

Jan 4th, 2012 - precod 10 

Denial on Nuclear Medicine

Hello, Can any one please help me on this.

We are billing for ancillary services of Nuclear medicine. We have billed 78452,93015,A9502,A9505,99070. But we are receiving denials for A9502,A9505,99070 stating as"INCLUDED IN GLOBAL RATE".

Please advise on how to get rid of this denial.

Jan 4th, 2012 - nmaguire   2,606 

re: Denial on Nuclear Medicine

When billing for the purchase of radiopharmaceutical(s), a copy of the bill indicating the dosage administered, unit price per dose, name and total charge of the radioactive drug must be made available to Medicare upon request. Private payers have their own policies on A9502 and A9505.
When requesting a written redetermination (formerly appeal), providers must include all relevant documentation with the request.
93015: Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report (You are not in an outpatient setting, if billing this code.). Code 99070 will be bundled (why is this being billed?).
See if this article helps because it is difficult to answer based on this information.
http://www.asnc.org/imageuploads/Coding-MPISPECT-June2010.pdf

Jan 11th, 2012 - precod 10 

re: Denial on Nuclear Medicine

Thank you so much for the solution.



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