CPT® 93015 Applies Only to Global Cardiovascular Stress Test

CPT® 93015 Applies Only to Global Cardiovascular Stress Test

Q: When we 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 and 93018 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only, the health plan has been paying only for 93016, stating there is a better way to bill for the service using a single code. This seems wrong to me. Can you offer insight?

A: There is a single code to report a complete cardiovascular stress test. CPT® Assistant (January 2010) explains:

The CPT coding for the stress test consists of three components:

  • Physician supervision of the test (code 93016),
  • ECG Tracing, the technical component (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]), and
  • Physician interpretation and report (code 93018).

Code 93015 [Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report] is used to report the complete cardiac stress test procedure, which includes all three components. Because code 93015 includes the technical component, supervision, and interpretation, this code is rightfully reportable only by a physician in a nonfacility setting (eg, office, clinic, or diagnostic testing center).

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CPT® Assistant further explains that a physician may properly report 93016 and 93018 individually, in the facility setting.

When a complete procedure (code 93015) is not performed, codes 93016-93018 are reported by the various providers according to the specific procedures that are actually performed…. In a facility setting (eg, hospital), the facility reports the technical component of the service and the physician(s) report the applicable component codes (eg, codes 93016 and 93018). Each physician should take care to report only those components of the stress test that he or she has actually provided ….

To restate: Code 93015 is appropriate only if all three components of the service are provided (e.g., the physician performs the test in a non-facility setting, using his or her own equipment). In a facility setting — where the facility reports the technical portion of the service — you are correct to report 93016, 93018.

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John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 402 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

2 Responses to “CPT® 93015 Applies Only to Global Cardiovascular Stress Test”

  1. Rakhee says:

    If Dr.A orders the stress test, Dr.B performs the stress test & Dr.C supervises the test in a non-facility setting(each physician employed by the facility and with their own unique provider identifier),can the facility bill 93015 alone? If not,how should it be coded?

  2. Bhavesh Patel says:

    can we use modifier 26 for 93015?

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