Wiki 2008 stress test in office

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taralyn1

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believe it or not I have walked into to some stress test for the office that were billed out as 93015 & 93017 At the end of May when I started working for the cardiologist the stress part itselft was billed w/96015 & 93017 than it seemed later in the year 93015 was paid for But because of the scarcity bonus I am confursed how to fix the in house stress test that were done previous to my arrival in 2008. The rest of the testing we have recvd pymt for it's just the reg stress. If a nuclear stress was done we got pd on the drugs just not the acutual stress itself. Any suggestions?

Thank you
Taralyn:confused:
 
HI Taralyn,

Does your physician own his equipment? If so then for "in house" stress tests you would bill with 93015. Keep in mind there are 3 components to a stress test; this is the reason for the different codes.

93015 - global, covers both professional and technical portion of the test

93016 - supervision only
93107 - tracing; or use of the equipment
93018 - interpretation and report.

For 2008 the correct code to use is 93015; the doctor owns his equipment, the test was supervised and a report was dictated.

If he is providing part of the service then you would bill with one of the other 3 codes. You would never bill 93015 & 93017 together.

As far as not getting paid for 93015 when performed with a nuclear study, research the denied claims to see what diagnosis' were used to bill. Medicare has an LCD list for cardiac diagnostic services; ekg, echocardiogram, stress echocardiograms, myocardial nuclear perfusion studies and transesophageal echocardiograms. If the correct code is not linked to 93015 this may be the reason for the denial.

I hope this helps and is easy to understand.

Dolores, CPC-CCC
 
93015

Thank you. The DR does own his own equip so I too bld it w/93015 w/no mod
The dx was correct. So, confused going to call live person @ mcr thank you for your response

Tara
 
Now I was told by mcr 93015 was incorrect b/c it had to be billed as a scaracity code? This primary ov never recvs scarcity code.


Thank you
tara
 
I dont know what a "scarcity' code is... I have never heard that term and have been doing billing for 20 years. Since the doctor owns the equipment the correct code is 93015 and POS 11. Could it have been denied for frequency? Did another dr perform a stress test on this pt?

Dolors, CPC - CCC
 
I'm wondering, are these stress tests being done in a Medicare HPSA designated area?

One of our offices is in a Medicare designated health professional shortage area and when a stress test is done in that particular office and the patient has Medicare, we have to unbundle the stress test and bill codes 93016, 93017, and 93018 to Medicare.

Jessica CPC, CCC
 
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