Pulmonology Coding Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: How should I code for a complex pulmonary stress test and a cardiac stress test when performed at the same time? Will I be reimbursed for both?

Arkansas Subscriber             Answer: You can bill these tests separately if you follow specific requirements. In the past, the Correct Coding Initiative (CCI) bundled these tests together because they are very similar. However, appeals were made saying that some patients need both tests. It was proposed that instead of doing one after the other, pulmonologists perform the tests simultaneously and should be paid for both. CCI now allows these tests to be billed separately if the physician meets the following guidelines:
  Use a different ICD-9 code for each test.
  Provide separate written reports for each test with different information and data and drawing different conclusions.
  Bill the complex pulmonary stress test with 94621 (Pulmonary stress testing; complex [including measurements of CO2 production, O2 uptake, and electrocardiographic recordings]) and the cardiac stress test with 93018 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only) with modifier -59 attached to 93018.