Wiki Inconclusive Stress Test

[JMillett]

I am wondering if during an exercise stress echocardiogram ( 93351, 93320 93325) if the patient needs to stop the test before reaching 85% of TMR I should be adding the mod. 52? The provider is still giving dx based on results obtained. There are times patient can not maintain excercise in order to reach 85% and there are times due to medications they are unable to reach the 85% threshold. Any advice would be greatly appreciated.

 

[Pam Warren]

If all of the heart structures are imaged and the provider was able to document a report, I wouldn't add the -52. There's nothing in CPT (or CPT Assistant) that addresses the inability to reach 85% TMR as a factor for reporting the code; for some patients this is not possible, even though all of the components of the echo are able to be completed. Full disclaimer: Not a cardiology expert!

 

[JMillett]

If all of the heart structures are imaged and the provider was able to document a report, I wouldn't add the -52. There's nothing in CPT (or CPT Assistant) that addresses the inability to reach 85% TMR as a factor for reporting the code; for some patients this is not possible, even though all of the components of the echo are able to be completed. Full disclaimer: Not a cardiology expert!

Thank you VERY much. I just wanted to confirm that I was doing it right. After a few weeks of vacation for some reason this came to mind and I was second guessing myself.