Radiology Coding Alert

Question: How should we code for the professional component of a stress test?


North Carolina Subscriber

Answer: You should report CPT 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) for the physician supervision. To code the written interpretation and report, you should also use 93018 (... interpretation and report only).

Professional: A patient complains of chest pain (786.50) and heart palpitations (785.1). The physician uses hospital equipment to perform a cardiac stress test. Your doctor supervises the stress test and provides a written interpretation and report.

Global: If your physician instead administers a stress test in the office, providing the procedure's technical component in addition to the supervision, interpretation and report, you should report 93015 (... with physician supervision, with interpretation and report). That code encompasses all of the procedure's components.

Use 93016-93018 to report the components of the test the physician performed if he didn't do the entire service.

Don't forget: The physician may initiate "stress" by using pharmacological agents, such as dobutamine (J1250, Injection, dobutamine HCI, per 250 mg) or Persantine (J1245, Injection, dipyridamole, per 10 mg). Report the appropriate HCPCS code to describe the agent, if the physician performed the test in the office setting where your practice supplied the drug.

If the provider performs the stress test in conjunction with either echocardiographic or nuclear medicine imaging, code these imaging studies in addition to the ECG portion of the exam.