Cardiology Question for the Week of January 29, 2018

Cardiology Compliance Question of the Week

Question:

I have a provider who billed 93015 for a cardiovascular stress test performed in the outpatient hospital setting, and the hospital billed the following code:

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

The provider’s claim was re-coded from 93015 to 93018. How should a cardiovascular stress test done in a facility when a physician provides supervision as well as interpretation and report?

Answer:

Codes 93015 through 93018 are used to report cardiovascular stress tests. Code 93015 is considered the global code and should be used only when a physician owns the equipment and employs the personnel in his office or clinic. This code describes the complete service including the tracing, physician’s supervision of the test interpretation, and report of the results.

To report supervision of a stress test performed in a hospital, report code 93016. Assign code 93018 for the interpretation and report:

93016 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report
93018 interpretation and report only

If one physician supervises and provides the interpretation and report, as in your case, code both 93016 and 93018. If one physician supervises the stress test, but another provides the interpretation and report, each would assign the code for the portion he did.

The technical component (tracing only) is described by code 93017, which is the code billed by the hospital.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.