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Mimi had asked for some medical coding help and if we would explain 93015 and that’s the CPT code for a cardio stress test. The background about a stress test is that they do them for various reasons but they’re actually testing the heart.

(Note: Correct code for this video is 93015- and has been replaced in the text versions)

Medical Coding Help — How to Code Cardio Stress Test

Medical Coding for Stress can be Physical or Chemical

So a stress test can be performed in several different ways. The key is to get the heart pumping and accelerate the heart and then graph it to see what its doing. So to create stress on the heart or… in the heart, they’ll use a treadmill, or exercise bike. There’s more than one type of treadmill that’s listed on the CPT code 93015, just in case when you’re reading the case and there’s a specific type of treadmill.

Another way that they can do this is by medication. I’ve actually had this done where they don’t want to physically get you up and work you on an exercise bike. They’re going to administer a medication that will race the heart.

Now when I had this done, they use 93105 because the physician was there and she administered the medication. She supervised the stress test so she stayed, she was right by my side and she interpreted and submitted a report. So that’s what you need… all of those factors have to be involved to use 93015.

Medical Coding Help — How to Code Cardio Stress TestWhen you need medical coding help and you go to 93100, I think those codes in there, each one is specific around 93015. It might be that she supervises but she doesn’t do the interpretation or report or she does the report only.

So just be very specific when you’re looking at 93105 that they did a stress test and it can be a chemical or… the drug-induced stress test or through exercise and that the physician has supervised and did the interpretation and the report, then 93015 applies.

 

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2016-11-20T23:38:45+00:00

About the Author:

Laureen Jandroep
CPC, COC, CPPM, CPC-I.,Sr. Instructor for CCO.us. Resides in southern New Jersey with her husband of over 20 years Anthony and four children. They are active parents and spend most of their time these days just being parents which they love.

2 Comments

  1. Kristin April 28, 2014 at 3:22 pm - Reply

    I’m finding that even when atherosclerosis 440.9 and hypertension are present, United Health Care is denying payment for a treadmill stress test 93015. Even after sending in documention, h & p, resting ekg, etc. Please advise.

    • Alicia Scott May 9, 2014 at 11:38 am - Reply

      Kristin have you considered a more specific atherosclerosis code? 440.9 is unspecified and UHC may not like that. With all the other testing do you know where the atherosclerosis is? Is it in the extremities? I suspect with all the options that are available to you for atherosclerosis they don’t feel a .9 is something they will pay on.

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