Internal Medicine Coding Alert

Question: Which CPT codes should I use for a cardiac stress test and a pulmonary stress test?

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Answer: Two codes describe pulmonary stress tests: 94620 (Pulmonary stress testing; simple [e.g., prolonged exercise test for bronchospasm with pre- and post-spirometry]) and 94621 (... complex [including measurements of CO2 production, O2 uptake, and electrocardiographic recordings]). Codes 93015-93018 describe cardiac stress testing. CPT defines 93015 as 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.

To determine which code to use, study your internist's medical documentation. Typically, when a physician administers a pulmonary stress test, he or she tests for bronchospasm using spirometry (94010, Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation).

If you report 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), make sure the physician used treadmill and bicycle exercises, and interpreted results and issued a report.