tci Part B Insider - 2004 Issue 4

Cardiac Stress Testing: Boost the Patient's Heart Rate Without Giving Yourself a Heart Attack

Carrier cracks down on Adenosine claims with poor documentation If you're not putting heart patients on a treadmill, then you'll need to do your own workout to create documentation to justify it. For patients requiring cardiac stress testing who can't exercise due to an illness or weakness, Medicare covers Adenosine ( J0152 ), a drug that increases the patient's heart rate to exercise levels. But Part B carrier Regence says many providers aren't providing full enough documentation to explain why patients can't exercise. Claims for Adenosine increased 169 percent from January 2001 to June 2002 nationally, the...

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