Cardiology Coding Alert

Question: At a facility, my physician provides stress tests (without treadmill) for patients. These are Lexiscan/nuclear tests, but he doesn’t do imaging. How should I code this?

Codify Subscriber

Answer: You should confirm the precise services performed, but the physician appears to be providing supervision, interpretation, and report for nuclear stress tests performed at a facility. If this is the case, you should 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.

 The facility will claim reimbursement for the stress test tracing and supplies it provides.

Based on your description, presumably another physician is providing (and will report) the nuclear imaging services, such as 78452-26 (Myocardial perfusion imaging, tomographic [SPECT] [including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed]; multiple studies, at rest and/or stress [exercise or pharmacologic] and/or redistribution and/or rest reinjection; Professional component).