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? Oregon Subscriber   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. On the claim, you should report the following procedure and diagnoses: 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. You'll find other CPT codes to represent stress tests, depending on the physician's involvement. Use these codes as the situation dictates: ¥ 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).