Billing and Coding: Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography

Cardiovascular stress testing (exercise or pharmacologic, including stress echocardiography) is covered when medically necessary and when results are likely to affect patient management. Routine or annual testing without individualized clinical indications—such as routine post-MI/CABG/PTCA testing in the absence of symptoms outside reassessment periods—is not reasonable and necessary. Comprehensive documentation (diagnosis, reason for test and modality, referral details, interpretation, supervision, and leasing contracts where applicable) must be maintained to support medical necessity and coverage.

"Stress testing (exercise or pharmacological, including stress echocardiography) is covered when the results will potentially affect the patient’s treatment plan."

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