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Official Description

Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93015 refers to a cardiovascular stress test that utilizes either maximal or submaximal exercise on a treadmill or bicycle, along with continuous electrocardiographic (ECG) monitoring. This procedure may also involve pharmacological stress if the patient is unable to perform physical exercise. The primary purpose of this test is to evaluate the electrical activity of the heart under stress conditions, which can provide valuable insights into the heart's function and overall cardiovascular health. During the test, small plastic patches, known as electrodes, are affixed to specific locations on the patient's chest, abdomen, arms, and/or legs. These electrodes are connected to leads from the stress ECG device, which records the heart's electrical activity. Initially, a baseline ECG is obtained to establish the heart's normal rhythm. Following this, the exercise component of the test is initiated, where the patient's heart rate and blood pressure are continuously monitored. A staged stress protocol is employed, allowing for a gradual increase in exercise intensity, and the patient's response to this stress is closely observed as the ECG data is recorded. The exercise or pharmacological stress continues until the patient reaches their target heart rate or is unable to continue due to fatigue or other contraindications. Upon completion of the test, the recorded stress ECG is thoroughly reviewed, and a comprehensive written interpretation of the findings is generated. This code encompasses the entire procedure, including supervision, interpretation, and reporting of results, which are critical for accurate diagnosis and treatment planning.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The cardiovascular stress test coded as CPT® 93015 is indicated for various clinical scenarios where assessment of cardiac function under stress is necessary. The following conditions may warrant the performance of this procedure:

  • Evaluation of Exercise Tolerance: This test is often performed to assess a patient's ability to tolerate physical activity, which can be crucial for determining fitness levels or the need for further cardiac evaluation.
  • Diagnosis of Coronary Artery Disease: The stress test can help identify the presence of coronary artery disease by observing the heart's response to increased workload.
  • Assessment of Cardiac Symptoms: Patients presenting with symptoms such as chest pain, shortness of breath, or palpitations may undergo this test to evaluate the underlying cardiac issues.
  • Preoperative Evaluation: Prior to certain surgical procedures, especially in patients with known cardiovascular risk factors, this test may be performed to assess cardiac risk.
  • Monitoring of Cardiac Rehabilitation: The test can be used to monitor progress in patients undergoing cardiac rehabilitation programs, ensuring that exercise regimens are safe and effective.

2. Procedure

The procedure for CPT® 93015 involves several key steps that ensure a comprehensive evaluation of the heart's function during stress:

  • Preparation: The patient is prepared for the test by having small plastic electrodes placed on specific areas of the chest, abdomen, arms, and/or legs. These electrodes are essential for capturing the heart's electrical activity throughout the test.
  • Baseline ECG Recording: A baseline electrocardiogram (ECG) is obtained to establish the patient's normal heart rhythm and electrical activity before any stress is applied.
  • Initiation of Exercise or Pharmacological Stress: The exercise component is initiated, which may involve walking on a treadmill or pedaling a stationary bicycle. If the patient is unable to perform physical exercise, pharmacological agents may be administered to simulate the effects of exercise on the heart.
  • Monitoring: Throughout the test, the patient's heart rate and blood pressure are continuously monitored. The staged stress protocol is followed, gradually increasing the intensity of the exercise while observing the patient's response.
  • Completion of the Test: The exercise or pharmacological stress continues until the patient reaches their target heart rate or is unable to continue due to fatigue or other contraindications. The stress ECG is recorded during this period.
  • Review and Interpretation: After the test is completed, the recorded stress ECG is reviewed, and a detailed written interpretation of the findings is provided, summarizing the heart's performance under stress.

3. Post-Procedure

After the completion of the cardiovascular stress test, patients may be monitored for a short period to ensure they recover adequately from the exercise or pharmacological stress. It is common for patients to experience mild fatigue or shortness of breath immediately following the test, but these symptoms typically resolve quickly. The healthcare provider will review the results of the stress ECG with the patient, discussing any significant findings and potential implications for further evaluation or treatment. Patients may be advised on activity levels and any necessary follow-up appointments based on the interpretation of the test results. Additionally, documentation of the procedure and findings is essential for accurate coding and billing purposes.

Short Descr CARDIOVASCULAR STRESS TEST
Medium Descr CV STRS TST XERS&/OR RX CONT ECG W/SI&R
Long Descr Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 4 - Global Test Only Code
Multiple Procedures (51) 6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services apply...
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 02 - Procedure must be performed under the direct supervision of a physician.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x)
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) T2B - Other tests - cardiovascular stress tests
MUE 1
CCS Clinical Classification 201 - Cardiac stress tests
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GA Waiver of liability statement issued as required by payer policy, individual case
GZ Item or service expected to be denied as not reasonable and necessary
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
MG The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
CR Catastrophe/disaster related
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
GC This service has been performed in part by a resident under the direction of a teaching physician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
GW Service not related to the hospice patient's terminal condition
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
KX Requirements specified in the medical policy have been met
X1 Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
MF The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
93 Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AR Physician provider services in a physician scarcity area
GP Services delivered under an outpatient physical therapy plan of care
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GX Notice of liability issued, voluntary under payer policy
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
JZ Zero drug amount discarded/not administered to any patient
MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
MC Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q3 Live kidney donor surgery and related services
QJ Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
SA Nurse practitioner rendering service in collaboration with a physician
SC Medically necessary service or supply
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