Question: Which modifier can I use when billing 93010, 93016, 93018, and 78452?
Medicare denied 93010, 93016, and 93018 because, the procedure or the procedure with a modifier are not compatible.
Illinois Subscriber
Answer: You can’t report 93016 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report) and 93018 (... interpretation and report only) together. There’s a combined CPT® code to report all three components of a cardiovascular stress test: 93015 (... with supervision, interpretation and report).
The CPT® codes that you should use are:
Tip: Code 93015 is the global cardiac stress test code that encompasses the entire stress test: equipment, physician supervision, and interpretation and report (I&R).
If your physician does not perform all three components, you should report the specific component code (93016-93018) that represents the physician’s role rather than using modifiers 26 (Professional component) or TC on 93015.