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Stress Test and J Code use- billed together??

  1. #1
    Question Stress Test and J Code use- billed together??
    Clearnace Sale
    Suddenly out of the blue, the doctor wants to bill 93015 when the patient can not walk on the treadmill. I think it's due to lower payments this year.

    This was billed as: Myocardial Perfusion Stress Test 78452, Cardolite A9500 x2 and J1245 dobutamine due to the patient having severe knee arthritis and is unable to walk on the treadmill.
    Now the doctor wants to bill in addition to all the above codes 93015. He says it's because he 'interprets' the EKG portion of the test. Can you bill a stress test 93015, if the patient didn't even attempt to walk on the treadmill?? I can not find anything that will 100% clarify this.
    For 12 years he didn't bill the 93015 and a J code if the patient couldn't walk on the treadmill, now suddenly he thinks this is how it should be. Does anyone have an answer and/or maybe know where I can find this in writing to show him? If we can bill it, great. But if not, I don't want to be there when he's audited... Thanks for the help!!
    Cindy, CPC

  2. #2
    You should be billing for the stress and the drug administered. The description of 93015 states "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." It's not exclusive to stress with a treadmill.
    Shannon, CPC, CCA

  3. #3
    Richardson, Texas
    Default Nuclear Stress Test Supervision
    I second the response posted above. The 93015 is for physician supervision, interpretation and report of the stress portion of the test -- regardless of how the patient is stressed (excercise or pharmacologically). 93016 is reported when the physician only supervises the stress portion and another physician performs the interpretation and report. Medical supervision of the stress portion of the test is required due to the risk to the patient.
    Linda Hallstrom, CPC, CPMA, CPC-I, CEMC
    Richardson, TX AAPC Chapter

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