Section 418.10505. Multiple procedure policy for specific nuclear medicine procedures.


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  • Rule 505. (1) The multiple procedure reduction and the use of  modifier -51 shall apply to the complete procedure, the technical component, and the professional component, when multiples  of   the  following   nuclear medicine diagnostic procedure codes are performed: 78802, 78803, 78806, and 78807.

    (2)   When the procedures listed in subrule (1) of this rule are performed in a hospital setting, the  hospital   is  reimbursed   by  the cost-to-charge methodology and the multiple payment rule shall    apply    to the professional component billed by the radiologist.

    (3)     When the services are performed  in   an  office,  clinic,  or freestanding radiology office, the reduction shall be applied to the complete procedure.

History: 2007 AACS.