Cardiology Coding Alert

Question: My cardiologist went off-site to oversee a stress test but did not hook up the patient to the machine. He was able to monitor about six patients at one time. How should I code this?


Missouri Subscriber

Answer: You should code the stress test this way:

• 93016--Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; physician supervision only, without interpretation and report

• 93018--...interpretation and report only.

If your cardiologist charges a stress echo supervision and interpretation with report, you need to report 93016 and 93018 for each patient he oversaw and did the interpretation and report for. If he supervised six patients at one time, you should code all six patients with 93016 and 93018.

Remember, if he was only supervising, you should report 93016 only. If he did only the interpretation and report, use 93018.

Keep in mind: You would report a complete stress test using 93015 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report). This code actually consists of three sub-components (93016-93018).

Sub-components: Think of the service represented by 93017 as the technical component of the service (in other words, providing the equipment, paying for rental space, utilities, technicians, supplies, and so on). The other portions (93016 and 93018) reflect the professional components. Code 93016 represents the physician's direct supervision of the test, which is required under Medicare's diagnostic test supervision guidelines. Code 93018 represents the physician's interpretation of the test data and rendering of a professional report.

Important: When your cardiologist provides a stress test in your office, you can report and get paid for all of these subcomponents by reporting 93015. When your cardiologist provides the same service at a facility, you should carve out his portion of the service by reporting just 93016 and 93018. The facility would report the technical component (93017) instead.