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CPT 78452 should not be billed when only a single-phase study is performed (use 78451), when documentation does not support medical necessity, or when services are bundled under National Correct Coding Initiative edits

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[375] In accordance with § 425.600(g), we use the following approach: If an ACO is determined to be inexperienced with performance-based risk Medicare ACO initiatives (as defined at § 425.20), [376] the ACO may enter either the BASIC track's glide path at any of the levels of risk and potential reward (Levels A through E), or the ENHANCED track