93025 Rule In the CCI Manual Gets an Update In 16.3

93025 Rule In the CCI Manual Gets an Update In 16.3

Conflicting guidelines are at the top of the frustrating realities of the coding list.

Here's a case in point: The CCI version for physicians that was released on July 1, this year provided information on coding MTWA and stress tests that conflicted with the CCI manual in effect that time. However, don't worry as the latest CCI edits 16.3 provides updated instructions that go hand in hand with the edits.

Update your CCI manual's chapter 11

The CCI edits effective July 1 deleted the edits that prevented reporting cardiovascular stress test codes 93015-93017 with MTWA code 93025.

The old version of the manual in effect at that time, however stated you could not report 93015- 93017 on the same date as 93025. The old wordings read, "If a physician carries out an MTWA with submaximal stress test followed by a traditional stress test on the same date of service, CMS payment policy allows separate payment of MTWA (93025) and the interpretation and report for the traditional stress test (93018). The practice expense component of the traditional stress test is not payable separately and a physician should not report CPT codes 93015-93017 on the same DOS as 93025."

The present manual's CCI updates reflect the CCI edit deletion that allows you to report both an MTWA with submaximal stress test and a traditional stress test, acknowledging that the tests are different. The present wording says, "Microvolt T-wave alternans (MTWA) (93025) testing needs a submaximal stress test that differs from the traditional exercises stress test (93015-93018) which makes use of a standard protocol. You shouldn't report separately for the submaximal stress test integral to MTWA testing. If a physician carries out an MTWA with submaximal stress test followed by a period of rest and then a traditional stress test on the same DOS, both the MTWA and traditional stress test may be reported separately (chapter 11, section I.9).

You can get the CCI manual chapters from the CMS website, or you may even sign up for a medical coding guide like Supercoder!

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