Internal Medicine Coding Alert

Published on Thu Mar 27, 2008 PDF

Question: How should we report our internist's services when he provides interpretation and report for a cardiovascular stress test? (The test occurred at the local hospital). I reported 93015 with modifier 26 (Professional component) appended but received a denial.

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Answer: You should only report 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) when the internist performs all of the stress test work and the practice owns the equipment.

The correct code for your encounter is 93018 (... interpretation and report only). Don't worry about appending any modifiers to this code; the descriptor exactly matches your internist's actions.

Also note these other cardiovascular stress test codes:

• 93016 (... physician supervision only, without interpretation and report). Report 93016 when the internist supervises the test.

• 93017 (... tracing only, without interpretation and report). Report 93017 when the internist provides only technical service, meaning someone other than your internist performs the test's interpretation, report and/or the supervision component.