Ask Dr. Z

My doctor is doing dual isotope adenosine nuclear stress test. Isotopes are Myoview (A9502) and Thalium (A9505). For patients who are not able to walk on a treadmill we are using adenosine injecting along with normal saline (J7050) for creating the stress. Here I have two questions: 1) We are using code A9502 (Myoview) 30 mci, for which we are coding two units, and we are using code A9505 (Thalium) 3.6 mci, for which we are coding four units. Are we correct in billing these two and four units for these isotopes as per dosage? 2) We are giving adenosine IV in mixture with normal saline. Does the dosage of this normal saline have to be 250 cc? Because the HCPCS code for normal saline (J7050) is showing for 250 cc... so could someone help me with this? Is it mandatory to use 250 cc normal saline solution in order to inject adenosine?