Internal Medicine Coding Alert

Question: How should I code an in-office pharmacological stress test, including the adenosine and the normal sterile saline?


Arkansas Subscriber

Answer: Assuming that your practice owns the stress-test equipment, you should report the global code 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). To code the adenosine, select J0152 (Injection, adenosine for diagnostic use, 30 mg [not to be used to report any adenosine phosphate compounds; instead use A9270]). For the sterile saline, choose A4216 (Sterile water/saline, 10 ml) or A4217 (... 500 ml), depending on the dosage.

Warning: Many commercial and Medicare payers may not pay separately for the saline because they consider it included in the stress-test service.