Internal Medicine Coding Alert

Question: An internist orders a cardiac stress test on a hospital patient who complains of chest pain (786.50) and palpitations (785.1). The physician supervises the stress test and provides a written interpretation and report. What cardiovascular stress test code should I use?

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Answer: You should report two procedure codes. For the physician supervision portion, report 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). For the written interpretation and report, use 93018 (... interpretation and report only).
 
Be careful: Do not use the comprehensive cardiac stress test code 93015 (... with physician supervision, with interpretation and report). Reserve this code for when the internist administers the stress test in the office, providing the procedure's technical component (that is, the internist's practice owns the equipment) in addition to the supervision, interpretation and report.
 
Difference: Code 93015 encompasses all of the cardiac stress test's components (for example, the use of the equipment, as well as the supervision, interpretation and report). Codes 93016-93018 break out the components into the parts of the test that the internist performed if he didn't do the entire service.