Internal Medicine Coding Alert

Question: My internist performed an electrocardiogram (ECG) prior to giving the patient a stress test. Should I report both procedures?

Alabama Subscriber

Answer: Yes, you may report the ECG with 93000 (Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report) and the stress test with 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).
 
If your internist did not provide the interpretation and report, use 93016 (... physician supervision only, without interpretation and report).
 
Most payers will cover an ECG when the physician uses it as a diagnostic tool before performing the stress test. For instance, your internist wants to confirm a diagnosis of coronary artery disease, such as 414.9 (Chronic ischemic heart disease, unspecified). The physician relies on the patient history, an ECG and the symptoms.