CPT code 93024 is used for a cardiac drug stress test, which evaluates heart function under stress induced by medication.
CPT code 93024 is used to describe a cardiac drug stress test. This procedure involves administering medication to simulate the effects of exercise on the heart. It is typically used for patients who are unable to perform physical exercise due to various health conditions. The test helps healthcare providers assess how well the heart functions under stress and can be crucial in diagnosing conditions such as coronary artery disease. The medication used in this test increases heart rate or dilates the coronary arteries, mimicking the effects of physical exertion, and the heart's response is monitored through imaging or electrocardiography.
For CPT code 93024, which pertains to a cardiac drug stress test, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when only the professional component of the service is being billed. It indicates that the provider is billing for the interpretation of the test results, not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed. It indicates that the provider is billing for the use of equipment and supplies necessary to perform the test, excluding the interpretation.
3. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. It may be necessary if the cardiac drug stress test is performed in conjunction with other procedures that are not typically reported together.
4. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider. It may be applicable if the cardiac drug stress test needs to be repeated on the same day due to clinical necessity.
5. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by a different provider. It may be applicable if the cardiac drug stress test is repeated on the same day by another provider for clinical reasons.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although less common for this specific procedure, this modifier is used when a laboratory test is repeated on the same day to obtain subsequent results. It may be relevant if the cardiac drug stress test is considered a diagnostic test and needs to be repeated for accuracy.
These modifiers help ensure accurate billing and reimbursement by clarifying the specific circumstances under which the cardiac drug stress test was performed. Always verify payer-specific guidelines, as modifier usage can vary.
CPT code 93024 is associated with a cardiac drug stress test. Whether this code is reimbursed by Medicare depends on several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the specific guidelines set forth by the Medicare Administrative Contractor (MAC) for the region in which the service is provided.
The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. If CPT code 93024 is listed in the MPFS, it is generally eligible for reimbursement, provided that the service is deemed medically necessary and all other Medicare coverage criteria are met.
However, it's important to note that each MAC, which administers Medicare claims for a specific geographic area, may have additional local coverage determinations (LCDs) that affect reimbursement. These LCDs can specify conditions under which the service is covered or outline documentation requirements that must be met for reimbursement.
Therefore, to determine if CPT code 93024 is reimbursed by Medicare, healthcare providers should consult the MPFS for the current year and review any relevant LCDs issued by their MAC. This ensures compliance with both national and local Medicare policies.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level, including CPT code 93024. Schedule a demo today to see how RevFind can help you identify discrepancies with individual payers and ensure you're receiving the full reimbursement you deserve.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
