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20/01/2021

Cardiovascular Stress Test

For Members:

  • What is Cardiovascular Stress Test?

It is an exercise stress test where heart’s electrical activity is checked while you are exercising to estimate the risk of heart diseases. Any abnormalities identified in the electrical activity indicates the presence of heart vessels disease. It is also known as ‘treadmill test’. During the test, the treadmill speed and slope is gradually increased at roughly 3-minute intervals.

It is highly recommended that you should not take heart/chest discomfort medications on the day of your test, unless your doctor advices. The test is performed on empty stomach that is why do not drink or eat anything at-least 4 hours before the test. Consuming caffeine 12 hrs before the test is strictly prohibited.

 

  • What are the Indications?
    • Symptoms like chest pain on excursion.
    • Recent Heart attack (Acute Coronary Syndrome) treated without angiography.
    • Known Heart vessel diseases with worsening symptoms.
    • Patients with Coronary artery bypass grafting (CABG) done for 5 years or longer.
    • Patients with Percutaneous Coronary Intervention (PCI)done for 2 years or less.
    • Valvular heart disease (to assess exercise capacity and need for surgical intervention)
    • Certain cardiac arrhythmias to assess the effect of heart stimulating medication (chronotropic competence).
    • Newly diagnosed heart failure or abnormalities.

 

  • What are the Contraindications?
    • Acute aortic dissection.
    • Acquired complete heart block.
    • Decompensated heart failure.
    • Inability to exercise.
    • Heart attack in previous two days.
    • High heart rate with palpitations (100 or above).
    • Slow heart rate (60 or below).
    • Heart Muscles Weakness.
    • Ongoing unstable Angina.
    • Symptomatic severe aortic stenosis.
    • Uncontrolled cardiac arrhythmia with hemodynamic compromise.
    • Known coronary artery disease.
    • Recent stroke.
    • Resting systolic blood pressure >200 mm Hg or diastolic blood pressure >110 mm Hg.

 For Healthcare Providers:

 

Recommendations:

  • All Cardiovascular Stress Test require prior approval from Nextcare.
  • The drug (if used) is not separately billable by the Physician. The IV administration of the drug (CPT codes 90765, 90768, 90772, 90774) is considered included in the stress test.
  • Additional modifier (CPT codes 93015, 93016, 93018) is not needed with the above mentioned codes.
CPT Description
93015 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise.
93016 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress: supervision only, without interpretation and report.
93017 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress: tracing only, without interpretation and report.
93018 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress: interpretation and report only.

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