Cardiology Coding Alert

Question: My cardiologist performed a tilt table test to evaluate a patient who has been experiencing symptoms of syncope. Which codes should I report on my claim? My cardiologist owns the tilt table equipment.

Michigan Subscriber

Answer: When your cardiologist performs a tilt table test, you should report 93660 (Evaluation of cardiovascular function with tilt table evaluation, with continuous ECG monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention). Your diagnosis code would be R55 (Syncope and collapse).

Tilt table test defined: In a tilt table test, the patient lies strapped to a table while the table slowly tilts upward. This “tilt” simulates transitioning from a lying down position to a standing up position, helping to trigger the patient’s symptoms.

During a tilt table test, the cardiologist monitors the patient’s blood pressure and heart rate for any changes that might occur. The cardiologist may need to administer isoproterenol or mechanical manipulation of peripheral blood flow with a variety of compression devices to produce the symptoms of syncope.

Caution: Code 93660 splits into professional and technical components. If the physician does not own the tilt table equipment, you should append modifier 26 (Professional component). The facility that owns the equipment will report the technical component.

But if the physician owns the tilt table, then you should report 93660 without a modifier because this global code includes both the professional and technical components.