Internal Medicine Coding Alert

READER QUESTIONS:

Use 93017, 93018 for Stress Tests Under NP, PA

Question: How do I bill for a nurse practitioner (NP) or physician's assistant (PA) who does a stress test without my physician present in the room?

Alabama Subscriber

Answer: Medicare's Medicare Benefit Policy Manual (IOM 100-02), Chapter 15, Section 80, states that 90317 is a level 2 supervision requirement. Report 93017 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report) or 93018 (... interpretation and report only), depending on the test performed. You must bill the NP/PA's test under his or her number and not your physician's number.

Best bet: Always check with the State Scope of Practice Law, or query the State Department of Nursing for clarification whether these services can be provided by mid-level practitioners in your area.

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