Coding for in-hospital cardiac stress testing with echocardiography and continuous EKG monitoring, if performed

Q.

When performing cardiac stress testing in a hospital setting what CPT^® codes should we be using for the echo and stress test? Our cardiologists do supervise the whole test. 

A.

If you are performing stress echo, there are two echo codes to choose from. The codes and complete descriptions are as follows:

93350 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;

93351 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional

CPT 93351 includes continuous EKG monitoring and the stress test is included. If you do not do continuous EKG monitoring, you would then instead assign CPT 93350 and, then you would also report the appropriate stress test code(s). If billing for the hospital you would report CPT 93017 for the technical component (tracing) of the stress test. If billing for the doctor supervising the stress test, report CPT 93016 and for the doctor interpreting and producing a report, report CPT 93018. The same doctor may or may not bill both CPT 93016 and 93018 depending on whether the same doctor supervises and interprets/reports. If you inject contrast during the stress echo, then also report CPT code 93352. The code and complete description are:

93352 Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure)