# Need help coding 2 day Stress Tests



## crhunt78 (Jan 11, 2012)

I am very new to Cardiology coding.  This is my 3rd day.    I need to learn how to code 2 day cardiac stress tests but have no clue where to start.  Can anyone help me?  

Thanks so much!


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## dimmitta (Jan 16, 2012)

*2 day stress test?*

I'm assuming that the doctor is wanting a full stress test done on day 1 and then for the patient to come back the next day for a follow-up stress test. If that is the case you would code a normal stress test as 93350, 93320, 93325, and either 93015 (if doctor is supervising and interpreting results) or 93018 (physician interpretation) and 93016 (physician/PA supervision) for day 1. Day 2 would most likely be a follow-up study billed as 93308. If you do not own the equipment all codes except 93015-93018 will need a 26 modifier. 

If this is not the correct scenerio please post a little more detail and I will see if I have another suggestion 

Hopefully this will help!


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## crhunt78 (Jan 17, 2012)

I have been using 78452 for multiple studies at rest and/or stress along with 93015 and then the drug codes A9500 and/or J2785 (if Lexiscan is used).  The patient has a stress test one day and then comes back the second day for the resting part of the exam.


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## dimmitta (Jan 17, 2012)

If you are using those drugs, then you are doing a MPI/SPECT and are billing the correct codes. Those are the drugs normally injected for this type of nuclear medicine testing. From what information I could find on the MPI, even if rest is done the next day you can still only bill the one MPI cpt. 

So basically, if it is standard protocol for the stress to be done on day 1 and day 2 is additional imaging for the rest portion, it is all included in the initial MPI code billed on day 1. If you have access to the CPT Assistant, look in May 2010 and Clinical Examples in Radiology, Winter 2010. 

Hope I didn't confuse you too much, lol! Also, I am in the Wichita area 
Have a great day!!


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## crhunt78 (Jan 17, 2012)

Thanks so much for your help!  Enjoy the warm weather you guys have been having!


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