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The CPT® Code 93017 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 is designed to assess the heart's electrical activity under stress conditions, which can be induced through physical exercise or pharmacological means. During the test, small plastic patches, known as electrodes, are affixed to specific areas of the patient's chest, abdomen, arms, and/or legs. These electrodes are connected to leads from the ECG device, allowing for the continuous monitoring of the heart's electrical signals throughout the test. Initially, a baseline ECG is recorded to establish the heart's normal activity before the stress is applied. The exercise phase of the test is then initiated, during which the patient's heart rate and blood pressure are closely monitored. A staged stress protocol is employed, meaning that the intensity of the exercise is gradually increased, and the patient's response to this stress is recorded via the ECG. The exercise or pharmacological stress continues until the patient reaches their maximum capacity or achieves a predetermined target heart rate, unless contraindications arise. Upon completion of the test, the recorded stress ECG is reviewed, but it is important to note that this code specifically refers to the tracing of the ECG without any interpretation or report of the findings. For a complete procedure that includes interpretation, other codes such as 93015 should be used, while 93016 is designated for supervision only without interpretation. The interpretation and report of the findings are captured under code 93018.
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The cardiovascular stress test represented by CPT® Code 93017 is indicated for various clinical scenarios where the evaluation of cardiac function under stress is necessary. The following conditions may warrant the performance of this procedure:
The procedure for CPT® Code 93017 involves several key steps that ensure accurate monitoring of the heart's electrical activity during stress. The following outlines the procedural steps:
After the completion of the cardiovascular stress test, the patient may be monitored for a short period to ensure their heart rate and blood pressure stabilize. Since CPT® Code 93017 specifically refers to the tracing of the ECG without interpretation, no formal report is generated at this stage. However, it is essential for the healthcare provider to review the recorded data for any abnormalities that may require further investigation. Patients may be advised to resume normal activities unless otherwise directed by their physician. Follow-up appointments may be scheduled to discuss the findings and any necessary further testing or treatment options based on the results of the stress test.
| Short Descr | CARDIOVASCULAR STRESS TEST | Medium Descr | CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY | Long Descr | Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 3 - Technical Component 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 | STV-Packaged Codes | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | GW | Service not related to the hospice patient's terminal condition | 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). | 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. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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 | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | 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 | SA | Nurse practitioner rendering service in collaboration with a physician | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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