Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Medical Services)
Anticoagulation Clinic-
S9401
Blood, Occult, Feces
Screening
Cardiovascular
Stress Test
11-14
Blue Cross will accept code S9401 for scheduled visits to an
anticoagulation clinic (S9401 – anticoagulation clinic, inclusive of
all services except laboratory tests, per session). This service will
be treated and reimbursed the same as the evaluation and
management (E/M) code 99211. Code S9401 will be subject to an
office call copay.
Code S9401 will not be allowed in addition to an E/M, unless the
E/M represents a significant separately identifiable service. If so,
the E/M should be appended with the –25 modifier and the
appropriate diagnosis linked. Additionally, some contracts may not
allow the service and/or code. For example, ‘S’ codes are not
accepted for our Medicare products.
Codes 82270 (blood, occult; feces, consecutive collected
specimens with single determination) is to be submitted with one
unit of service.
This screening typically tests three specimens, but units of service
should reflect the series, not number of specimens.
The date of service submitted should be the date the test card is
returned to the clinic.
Codes 82271 and 82272 are also limited to one unit of service.
Code 93015 is the global code for a cardiovascular stress test,
which includes both the professional component (interpretation,
report, and physician monitoring) and the technical component
(tracing). Submit code 93016 for physician supervision only,
without interpretation and report. Submit code 93017 for the
technical component only. Submit code 93018 for the professional
component only, which includes interpretation report and
physician monitoring. Submit prolonged services (codes 99354-
99357) only if acute intervention is required beyond routine
physician monitoring during the test.
The monitoring of a patient by a physician during a cardiovascular
stress test is considered an integral part of the professional
component of the test and not reimbursable as a separate service.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (06/20/12)