To report the thallium, use A9505 (Thallium tl-201 thallous chloride, diagnostic, per millicurie). For the Lexiscan, use J2785 (Injection, regadenoson, 0.1 mg), and assign A9502 (Technetium tc-99m tetrofosmin, diagnostic, per study dose) for the Myoview.
| Code | Code Description |
|---|---|
| I24.0 | Acute coronary thrombosis not resulting in myocardial infarction |
| I24.8 | Other forms of acute ischemic heart disease |
| I24.9 | Acute ischemic heart disease, unspecified |
| I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris |
What are the coding requirements for Lexiscan a?
Coding requirements vary by payer. 1 The coding systems in the following tables can assist you in coding for Lexiscan a: Atherosclerosis of coronary artery bypass graft (s), unspecified, with angina pectoris with documented spasm
What is the ICD 10 code for echocardiography?
DOPPLER ECHOCARDIOGRAPHY COLOR FLOW VELOCITY MAPPING (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHY) The following list of ICD-10-CM codes applies to cardiovascular stress testing CPT codes 93015, 93016, 93017, 93018, 93350, 93351 93352 and J0153.
What are the indications for Lexiscan thallium stress testing?
PROCEDURE PERFORMED: Lexiscan thallium stress testing. INDICATIONS FOR PROCEDURE: A 62-year-old female with a history of mitral valve disease. PROCEDURE IN DETAIL: The patient was brought to the nuclear suite at which time rest dose of thallium was injected via peripheral vein followed by the rest scan images.
What is the CPT code for a Lexiscan?
Cardiovascular Stress Testing CPT code 93015, 93016, 93017, J2785 – lexiscan, usage. Lexiscan is supplied as a standard-dose prefilled syringe: Injection solution containing regadenoson 0.4 mg/5 mL (0.08 mg/mL).
Is Lexiscan the same as regadenoson?
LEXISCAN® (regadenoson) injection is a pharmacologic stress agent indicated for radionuclide myocardial perfusion imaging (MPI) in patients unable to undergo adequate exercise stress. The recommended dose of LEXISCAN is 5 mL (0.4 mg regadenoson) administered as an intravenous injection within 10 seconds.
How do you code for nuclear stress test?
78452 : Nuclear stress : Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/ ...
What is the difference between a Lexiscan and a nuclear stress test?
What is an Adenosine or Lexiscan nuclear scan? It is similar to the exercise nuclear stress test except for the fact that Adenosine or Lexiscan is used to stress the heart. Adenosine is infused over 4-6 minutes, while Lexiscan is given over a few seconds.
What is a cardiac Lexiscan?
Lexiscan or Adenoscan are administered by intravenous injection during a cardiac nuclear stress test to patients who cannot adequately exercise. These drugs dilate the coronary arteries and increase blood flow so that coronary artery obstructions can be identified.
What is another name for Lexiscan?
LEXISCAN® (regadenoson) injection is a pharmacologic stress agent indicated for radionuclide myocardial perfusion imaging (MPI) in patients unable to undergo adequate exercise stress.
What is the ICD 10 code for stress test?
(L34598) Cardiovascular Stress Testing ICD-10 Codes That Support Medical Necessity and Covered by Medicare Program: Group 1 Paragraph: Diagnosis codes must be coded to the highest level of specificity.
What is ICD 10 code for abnormal stress test?
39 - Abnormal result of other cardiovascular function study.
What diagnosis will cover stress test?
Stress tests are most often used to: Diagnose coronary artery disease, a condition that causes a waxy substance called plaque to build up in the arteries. It can cause dangerous blockages in blood flow to the heart. Diagnose arrhythmia, a condition that causes an irregular heartbeat.
What is the difference between a chemical stress test and a nuclear stress test?
A regular stress test shows the EKG, heartrate and blood pressure while you are walking on a treadmill. A nuclear stress test shows your physician pictures of the blood flow to the heart muscle, in addition to the EKG, heartrate and blood pressure.
What is the difference between Lexiscan and dobutamine stress test?
Dobutamine is used to treat cardiogenic shock and heart failure. Lexiscan is given in preparation for a radiologic (X-ray) examination of blood flow through the heart to test for coronary artery disease. Dobutamine is a catecholamine and Lexiscan injection is a stress agent.
What is the difference between a stress echo and a nuclear stress test?
Also, while a stress echo uses an ultrasound to produce images of the heart, a nuclear stress echo uses a radioactive dye that is injected into the bloodstream.
Coding and Billing
Lexiscan Support Solutions a provides assistance with coding and billing questions relating to Lexiscan ® (regadenoson) injection.
Coding and Billing Reference Sheets
Appropriate and accurate coding is important for healthcare providers to receive reimbursement for Lexiscan. Coding should reflect services provided to patients as documented in the patient's medical record. b
General Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS National Coverage Policy
Title XVIII of the Social Security Act (SSA), 1862 (a) (1) (A), states that no Medicare payment shall be made for items or services that “are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.” Title XVIII of the Social Security Act, 1862 (a) (7) and 42 Code of Federal Regulations, Section 411.15, exclude routine physical examinations. Title XVIII of the Social Security Act, 1833 (e), prohibits Medicare payment for any claim lacking the necessary documentation to process the claim. CMS Manual System, Pub.
Article Guidance
Article Text The following coding and billing guidance is to be used with its associated Local coverage determination. Supportive documentation evidencing the condition and treatment is expected to be documented in the medical record and be available upon request. Documentation in the patient’s medical record must substantiate the medical necessity of the service, including the following: • A clinical diagnosis, • The specific reason for the study, • Reason for performing a stress echocardiogram as opposed to only an electrical stress test, • The reason for using any pharmacological stress, and • The reason for a stress echocardiogram if a stress nuclear test is also performed for the same patient for the same clinical condition. Document the referral order (written or verbal) in the patient’s medical record.
ICD-10-CM Codes that Support Medical Necessity
The following list of ICD-10-CM codes applies to cardiovascular stress testing CPT codes 93015, 93016, 93017, 93018, 93350, 93351 93352 and J0153. Since J0395, J1245, and J1250 may be billed for indications other than pharmacological stress agents with cardiovascular testing, the use of these drugs is not subject to the following list of ICD-10-CM diagnoses:.
ICD-10-CM Codes that DO NOT Support Medical Necessity
Any diagnosis inconsistent with the Indications and Limitations of Coverage and/or Medical Necessity section, or the ICD-10-CM descriptors in the ICD-10-CM Codes That Support Medical Necessity section.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
What is the code for stress echocardiogram?
Code 93350 is used to report the performance and interpretation of a stress echocardiogram only. Bill codes 93015–93018 if the stress test is performed in a hospital setting, along with procedure code 93350. If the stress test and echocardiogram are performed in an office, bill combined code 93351.
What are the contraindications for angina?
Contraindications may include, when used for diagnostic purposes, patients with the following diseases, signs or symptoms: Clinically significant acute myocarditis or pericarditis. Signs of unstable progressive angina. This includes the patient who has long periods of angina of fairly recent onset while at rest.
Contraindications
- Do not administer Lexiscan to patients with second- or third-degree AV block or sinus node dysfunction unless these patients have a functioning artificial pacemaker.
Warnings and Precautions
- Myocardial Ischemia Fatal and nonfatal myocardial infarction, ventricular arrhythmias, and cardiac arrest have occurred following Lexiscan injection. Avoid use in patients with symptoms or signs of acute myocardial ischemia, for example unstable angina or cardiovascular instability; these patients may be at greater risk of serious cardiovascular reactions to Lexiscan. Cardiac re…
Adverse Reactions
- In clinical trials, the most common adverse reactions (≥5%) to Lexiscan were dyspnea, headache, flushing, chest discomfort, angina pectoris or ST-segment depression, dizziness, chest pain, nausea, abdominal discomfort, dysgeusia, and feeling hot. Most adverse reactions began soon after dosing, and generally resolved within approximately 15 minutes, except for headache, whic…
Indication
- Lexiscan is a pharmacologic stress agent indicated for radionuclide myocardial perfusion imaging (MPI) in patients unable to undergo adequate exercise stress.
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