In section: Cardiovascular stress test, there is a section titled "Cardiovascular Stress Testing."
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No Medicare payment shall be made for items or services that are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member according to Title XVIII of the Social Security Act.Title XVIII of the Social Security Act prohibits Medicare payment for claims without the necessary documentation.Chapter 13, 50-50.4 and the Medicare claims processing manual are included in the Pub.There is a separate payment for the supply of a radiopharmaceutical diagnostic imaging agent and/or pharmacologic stressing agent with diagnostic nuclear medicine procedures.The system is called theCMS Manual System.Chapter 15, 50, is in the Medicare Benefit Policy Manual.There is coverage for drugs and biologicals in this section.Supplies, regarding pharmaceutic stressing agents, are in the Medicare National Coverage Determinations Manual.The repeal took place on February 22, 2010.100-04, Ch.32, 140.The Code of Federal Regulations (CFR), 42 CFR 410.32, states that all diagnostic tests must be ordered by the physician who is treating the beneficiary.The system is called theCMS Manual System.The Medicare Benefit Policy Manual has requirements for ordering and following orders for diagnostic tests.The Medicare claims processing manual explains coverage for preoperative evaluations.Chapter 13 of the Medicare claims processing manual deals with payment conditions for radiology services.The system is called theCMS Manual System.The Requirements for Diagnostic X-Ray, Diagnostic Laboratory and other Diagnostic Tests set forth the various levels of physician supervision required for diagnostic tests.
The local coverage determination is dependent on the following coding and billing guidance.
It is expected that supportive documentation be documented in the medical record and be available upon request.If a referring physician calls a cardiologist to order a stress echocardiogram, the test report or office record must document the date, name, and reason for the referral.For tests performed by leased employees, maintain the lease contract on file in the office and submit it to the contractor for review upon request.A follow-up test in the absence of symptoms or clinical indications is not necessary.Individualized clinical indications are not necessary for annual testing.A patient who has had a coronary revascularization procedure may need an initial stress test several months later and a second one a year later.A patient who presents with no reliable signs or symptoms may need testing as often as annually.A patient who initially presents with reliable symptoms will not need annual testing.An additional follow-up test once every five years may be sufficient if the clinical information is sufficient to reliably monitor the patient.
The add-on codes 93320, 93321 and 93325 are not all-inclusive.The primary codes are relevant to this policy.Add-on codes can be used with code 93320, 93350, and 93321.
Providers may be able to identify those Bill Types typically used to report this service with the help of contractors.Absence of a Bill type does not mean that the article doesn't apply to it.The article should be assumed to apply equally to all claims if there is no Bill Types.