R 418.10505 Multiple procedure policy for specific nuclear medicine procedures.

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: 78306, 78320, 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.