Radiology Coding Alert

Question: Our radiologist administered a cardiac stress test in the office (he owns the equipment) for a morbidly obese patient with chest pains. The radiologist also performed the supervision, interpretation and report. How should I report this encounter?

Answer: Because your physician had the equipment in the office -- and he performed all aspects of the test -- you can report both the procedure's technical and professional components.

• 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) for the stress test
• 786.50 (Chest pain, unspecified) linked to 93015 to represent the patient's chest pain.
• 278.01 (Morbid obesity) linked to 93015 to represent the patient's obesity.

• ¥ If the physician oversees the stress test but does not interpret results (an unlikely scenario for a radiologist), 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).
• ¥ If the physician owns the tracing equipment but does not interpret test results (again unlikely for a radiologist), 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).
• ¥ If the physician only interprets test results, report 93018 (Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only).

Heads up: You'll see both 93016 and 93018 for hospital-based stress tests. This is because physicians perform the service's supervision and interpretation portions, but they do not incur the technical expense (including providing the equipment).