Cardiology Coding Alert

Answer: According to the national Correct Coding Initiative (CCI), 90780 (IV infusion for therapy/ diagnosis, administered by physician or under direct supervision of physician; up to one hour) is an inherent part of a dobutamine stress test (93015, cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report), says C.J. Wolf, MD, CPC, senior coding consultant with Intermountain Health Care, a multispecialty practice in Salt Lake City.

The CCI edit confirms that the code already includes the injection of pharmacologic agents, such as dobutamine, to stress the heart. Therefore, infusion code 90780 cannot be billed separately. If you report both 93015 and 90780 for the stress test, it is considered unbundling, Wolf says, noting that most major payers follow HCFAs lead in this matter.

According to Medicare, the appropriate way to code for a dobutamine stress test is 93015 for the professional work and J1250 for the supply of dobutamine.