Cardiology Coding Alert

Hint: Never report 93350 together with 93015.

When your cardiologist performs a cardiac stress test using a submaximal or maximal treadmill, pharmacological stressor, or an exercise bike, you must check the medical documentation carefully for important details like which components of the cardiac stress test your cardiologist performed. Additionally, if your cardiologist performed a stress echo with a stress test, you must follow specific rules when reporting these codes together.

Read on to learn more.

Identify Complete Cardio Stress Test Code

You should report 93015 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report) when your cardiologist performs a complete cardiac stress test service. Code 93015 is a global code, which includes the cardiologist’s supervision of the test, the supply of the equipment, tech, and electrocardiogram (ECG) tracing, and the cardiologist’s interpretation and report.

Don’t miss: “Because code 93015 includes the technical component, supervision, and interpretation, this code is rightfully reportable only by a physician in a nonfacility setting (eg, office, clinic, or diagnostic testing center),” according to CPT^® Assistant Vol. 20, No. 1. Also, it would only be appropriate to report code 93015 if just one physician performs all three components of the 93015 service in a nonfacility setting.

Coding example: Your cardiologist, Dr. Overman, performed a maximal treadmill cardio stress test for a patient in his office. According to his medical documentation, Dr. Overman continuously monitored the patient’s heart rate, breathing, blood pressure, and level of tiredness during the procedure. Dr. Overman owns his equipment, employs the treadmill tech, and he provided his interpretation and report of the ECG data and the patient’s hemodynamics collected during the procedure. You would report 93015 for this scenario because one physician performed all three components of the 93015 cardiac stress test service in his office.

Rely on These Stress Test Component Codes

On the other hand, if your cardiologist does not perform the entire 93015 service and instead only performs a portion of the service, you should turn to the following component codes:

• 93016 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharma­cological stress; supervision only, without interpretation and report). This is a professional component of the cardiac stress test. You should report code 93016 for the physician’s supervision only.
• 93017 (… tracing only, without interpretation and report). This is the technical component of the cardiac stress test. You should report code 93017 for the ECG tracing only. This component includes technicians, providing the cardiac stress test equipment, paying for the rental space, utilities, and supplies.
• 93018 (... interpretation and report only). This is a professional component of the stress test. You should report code 93018 for the physician’s interpretation and written report only.

Don’t miss: If your cardiologist performs a cardiac stress test in a facility setting such as a hospital, he should follow specific reporting rules. In this case, the hospital would report the technical component of the test (93017), and your cardiologist would report the appropriate code for the specific service he performed — either 93016, 93018, or both codes, according to CPT^® Assistant.

Coding example: Your cardiologist, Dr. Bell, performed an exercise bicycle stress test for a patient in the hospital. Dr. Bell performed the direct supervision of the stress test. Dr. Bell also performed the interpretation and provided a written report for the test findings. In this case, the hospital would report 93017 for the technical component since they own the stress test equipment. On his claim, Dr. Bell would report 93016 for his direct supervision and 93018 for his interpretation of the test and written report.