Laureen: Right. The next question is about bubble. I love it now, people are asking questions based on bubbles, 93015 to 93018. If you’re kind of new to CCO and our teaching methodologies, in CPT especially we talked about bubbling and highlighting your book so things are kind of grouped together.
Q: There’s this bubble here, 93015 cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; (everything after the semicolon is bolded and that’s what makes the difference between the remaining indented codes 93016, 93017, and 93018)
Medical Coding Training | 93015 93018 | Bubble and Highlighting™ Example – Video
A: I’m going to show you my answer sheet because I kind of pulled in scans of my CPT manual so you can see what I’m talking about.
Here it is taken from SuperCoder or from the CPT manual. Here it is in actual image from my CPT manual. This is how I bubble and highlight things, so I can see things in context and make notes and all that good stuff.
Here’s the semicolon – with supervision, interpretation and report – that makes this what we call a total code because normally when equipment is involved, like radiology equipment or in this case this cardiovascular stress testing equipment, sometimes you want to report the professional component of what was done. Sometimes you want to report the technical component of what’s done, sometimes you want to report both. So, really it depends on who owns the equipment and who should be billing for it. So, if the entity that’s doing this test owns the equipment and they also pay the physician to do the interpretation or report, then they’re going to code 93015, that’s the total code.
93016 says supervision only, without interpretation and report. So, this is kind of like a professional component. I used to when I was teaching the class, put a 26 there to remind people. But then they thought they’re supposed to put 26 on and you’re not. I’m just trying to indicate that this is the professional portion of this code, of the situation here that you’re trying to code.
93017 is tracing only, without interpretation and report. So that’s a technical piece. 93018 is interpretation and report only. So that’s a professional piece. If you only did the supervision only, then that’s going to be your 93016. So you want to code what your physician did, if an entity that owns the equipment and the physician did all the work, they’re going to code 93015.
Now, on all of these codes, the modifier-26 and modifier TC does not apply because there are individual codes that can tell that story. The only time you use modifier-26 is when you have one code only and you need to report that, you only did the professional portion of that code or the technical portion of that code. Just to help round that out, I found an example from SuperCoder. So this is a reader question from the “Cardiology Coding Alert,” and it said, “If the cardiologist performed supervision and interpretation for a stress test performed on a patient under observation at a hospital should I still report a 93015?” And 93015 as you remember is the total code where they’re getting paid for all the professional pieces and the technical piece. And the answer is you should report the code that represents the specific services that the cardiologist provided. So, the cardiologist wasn’t providing the equipment, the hospital was. So, that cardiologist should not be getting paid for the technical piece, so they should either report 93016 or 93018 based on what they did. That was basically the answer for that. So, hopefully that will help you with that one.