Radiology Coding Alert

Coding stress tests can take you out of CPT's designated Radiology Section, so watch out for these clues that you need to look to the manual's Medicine Section instead.

CMS requires direct supervision for cardiac stress testing. So if you code for the physician who provided supervision and interpretation of the study's stress component, you should report a code from the 93015-93018 series, says independent coding consultant and coding instructor Linda Templeton, CCS-P, CPC, CPC-H, who also codes nuclear medicine procedures for a large teaching hospital in southeast Michigan.

Watch out: Two of these codes' descriptors state "interpretation and report," and two state "without interpretation and report." A radiologist likely won't provide these services without interpretation and report.

With: You would report 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) if your physician administers a cardiovascular stress test in the office, providing the procedure's technical component (that is, the physician's practice owns the equipment, employs the staff, pays the rent, pays the utilities, etc.) in addition to the supervision, interpretation and report.

If the physician only interprets test results, submit 93018 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only).

Without: If the physician oversees the stress test but does not interpret results, report 93016 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; physician supervision only, without interpretation and report).

And if the physician owns the tracing equipment but does not interpret test results, 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).