How To Use CPT Code 93464

CPT 93464 describes the physiologic exercise study performed by a healthcare provider to assess the heart’s response to physical stress. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93464?

CPT 93464 is used to describe a physiologic exercise study conducted by a healthcare provider to evaluate the heart’s ability to withstand physical stress. This study involves measuring various hemodynamic parameters, such as cardiac output, blood flow, pressures, and oxygen levels, before and after the exercise. The exercise can be performed using a stationary bike or an arm ergometer, and it is typically done in conjunction with cardiac catheterization.

2. Official Description

The official description of CPT code 93464 is: ‘Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other relevant codes for cardiac catheterization and associated procedures.

3. Procedure

  1. After performing cardiac catheterization, the healthcare provider has the patient engage in exercise, either on a stationary bike or with an arm ergometer, to increase their heart rate.
  2. While the catheters are in place, the provider measures various hemodynamic parameters, including cardiac output, pressures, and oxygen saturation, before, during, and after the exercise.
  3. The exercise session is carefully monitored to ensure the patient’s safety and to collect accurate data on the heart’s response to physical stress.
  4. The provider records the measurements and assesses any changes in the hemodynamic parameters before and after the exercise.
  5. This procedure helps evaluate the heart’s function and its ability to handle physical exertion.

4. Qualifying circumstances

CPT 93464 is typically performed in conjunction with cardiac catheterization. It is used to assess the heart’s response to exercise and evaluate its ability to withstand physical stress. This procedure is appropriate for patients who require further evaluation of their cardiac function and who may be at risk for cardiovascular disease or other heart-related conditions. The exercise study helps determine the patient’s exercise tolerance and provides valuable information for treatment planning.

5. When to use CPT code 93464

CPT code 93464 should be used when a healthcare provider performs a physiologic exercise study to assess the heart’s response to physical stress. This code should be reported in addition to the primary procedure code for cardiac catheterization or other relevant procedures. It is important to ensure that the exercise study is performed using a stationary bike or an arm ergometer and that the hemodynamic measurements are taken before and after the exercise session.

6. Documentation requirements

To support a claim for CPT code 93464, the healthcare provider must document the following information:

  • Indication for the physiologic exercise study
  • Details of the exercise session, including the type of exercise (stationary bike or arm ergometer)
  • Hemodynamic measurements taken before and after the exercise
  • Cardiac output, pressures, and oxygen saturation values
  • Any significant changes observed during the exercise study
  • Relationship to the primary procedure (cardiac catheterization or other relevant procedure)

7. Billing guidelines

When billing for CPT code 93464, ensure that the physiologic exercise study is performed in conjunction with a primary procedure, such as cardiac catheterization. This code should be listed separately in addition to the primary procedure code. It is important to follow the guidelines provided by payers regarding the appropriate use of this code and any associated modifiers. Remember to report CPT code 93464 only once per catheterization procedure and to use it in conjunction with other relevant codes for a comprehensive billing.

8. Historical information

CPT code 93464 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates or changes to the code since its addition.

9. Examples

  1. A patient undergoes cardiac catheterization, and during the procedure, the healthcare provider performs a physiologic exercise study using a stationary bike to assess the heart’s response to physical stress.
  2. After cardiac catheterization, the provider conducts a physiologic exercise study with an arm ergometer to evaluate the heart’s ability to withstand physical exertion in a patient with suspected cardiovascular disease.
  3. A healthcare provider performs a physiologic exercise study as part of a comprehensive evaluation for a patient with exercise-induced symptoms, using a stationary bike to assess the heart’s response to physical stress.
  4. During a cardiac catheterization procedure, the provider includes a physiologic exercise study using an arm ergometer to evaluate the heart’s function and exercise tolerance in a patient with known heart disease.
  5. Following cardiac catheterization, the healthcare provider conducts a physiologic exercise study with a stationary bike to assess the heart’s response to physical stress and determine the patient’s exercise capacity.
  6. A patient undergoes cardiac catheterization, and as part of the procedure, the provider performs a physiologic exercise study using an arm ergometer to evaluate the heart’s ability to handle physical exertion.
  7. After cardiac catheterization, the provider includes a physiologic exercise study with a stationary bike to assess the heart’s response to exercise and determine the patient’s exercise tolerance.
  8. A healthcare provider performs a physiologic exercise study using an arm ergometer to evaluate the heart’s function and exercise capacity in a patient with suspected cardiovascular disease.

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