Wiki nuclear stress test what codes?

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melissalynnfalkowski

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TYPE OF STRESS TEST: Lexiscan Cardiolite

INDICATIONS: Positive risk factors, history of chest pain, EKG abnormality, patient is unable to exercise because of chronic back pain.

CONSENT: Before the procedure, the patient provided written consent.

HISTORY: Baseline EKG shows sinus rhythm with poor R-wave progression in the anterior leads, and maybe a hint of inferior ST depression in II and III. Baseline blood pressure is 136/74. Baseline heart rate is 85 beats per minute.

DESCRIPTION OF PROCEDURE: 0.4 mg of Lexiscan was given over 10 seconds. Immediately after infusion the patient denied any chest pain. Blood pressure was 128/75, pulse 88. The EKG remained at baseline abnormality. However, during recovery there was some QT prolongation, but the patient had no chest pain. At 4 minutes of recovery, the patient's blood pressure was 130/74 with heart rate of 86. EKG, as mentioned, involved some mild QT prolongation. There was no other ST-T abnormality.

IMPRESSION:

Baseline abnormal EKG with positive risk factors. There is no lexiscan-induced chest pain or shortness of breath.
Baseline abnormal EKG with Lexiscan shows no diagnosed ST depression or ST elevation; however, there is a QT prolongation with Lexiscan infusion.
Final nuclear imaging depending on Radiology interpretation.
 
What codes are you leaning towards for this? My providers perform these in the hospital and with the documentation you provided I would code 93016 and 93018.
 
if performed in office it would be 93015, if also the nuclear part would be either 78451 or 78452 and any medicines. If in the hospital we use the 93016 and 93018 and add 26 to the nuclear
 
Hi! we do stress test and Nuclear pet scans. For our stress we do 93018,93016, 93017, 78452 TC, 78452-26, A9500 for in the office. At hospitals just 93018,93016 and 78452-26.
 
I have a question regarding these situations. I am new to this and am only filling in for a co-worker this week. We also do the 93016 and 93018 (along with the 78452-26) but my question is this, why not use the 93015 (when the physician supervises the test), or am I really just getting more and more confused. Thanks.
 
penswhitex said:
I have a question regarding these situations. I am new to this and am only filling in for a co-worker this week. We also do the 93016 and 93018 (along with the 78452-26) but my question is this, why not use the 93015 (when the physician supervises the test), or am I really just getting more and more confused. Thanks.
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Is the test being done with your equipment? Based on the fact you say you bill 93016, 93018, along with 78452-26 I would guess no. If it's not being done with your equipment you don't have the 93017 portion of the stress test. Since you aren't doing that portion, can't do the global 93015 code.

Jessica CPC, CCC
 
No, it's done at the hospital. I knew there had to be a simple reason why it wasn't billed this way but was mainly just curious.
 
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