Part B Insider (Multispecialty) Coding Alert

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Keep Stress Tests Modifier-Free

Let definitions guide you when choosing the right code

If your carriers are stopping your cardiac stress test claims in their tracks, you might be making a common - and easily avoidable - mistake.

You don't have to attach modifier -26 (Professional component) or  -TC (Technical component) to cardiac stress test codes 93015-93018 because the CPT descriptors break out the components for you, says Lisa Center, CPC, quality review coordinator for Freeman Health System in Joplin, MO.

Helpful key: Use the definitions below to note which codes represent the professional, technical or global components:

  •  CPT 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.

    This is the global code, which describes the test's technical component, the physician's supervision, interpretation and report. Use this code when the physician performs all of the work and the practice owns the equipment.
     

  •  93016 - ... physician supervision only, without interpretation and report.

    Submit this code only for the physician's supervision, which is a professional service (equipment is not owned by the physician).
     

  •  93017 - ... tracing only, without interpretation and report.

    This code represents the physician's technical service, which means someone other than the physician provided the interpretation, the report and/or the supervision component.
     

  •  93018 - ... interpretation and report only.

    You should use 93018 for the professional services of interpretation and report (equipment is not owned by the physician).

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