Summary & Overview
CPT 93024: Ergonovine Provocation Test for Coronary Artery Spasm
CPT code 93024 is billed for an ergonovine provocation test used to evaluate for coronary artery spasm by administering ergonovine and monitoring for chest pain and electrocardiographic changes. This diagnostic cardiac procedure has clinical importance for identifying vasospastic angina, guiding management, and informing downstream care decisions. Nationally, the code is relevant to hospital-based cardiology services and ambulatory cardiac catheterization centers that perform invasive or monitored diagnostic testing.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the test, the typical sites of service, and payer coverage considerations. The publication also summarizes available benchmarks, coding and billing considerations, and recent policy updates that affect reimbursement and documentation requirements. Clinical implications for patient selection and test interpretation are provided to clarify when the procedure is clinically indicated.
This summary is intended for a national audience of clinicians, coding professionals, and policy analysts seeking a clear, practical briefing on CPT code 93024 and its role in diagnostic cardiovascular care.
Billing Code Overview
CPT code 93024 describes an ergonovine provocation test for coronary artery spasm, a diagnostic procedure in which the provider administers ergonovine and monitors the patient for chest discomfort and electrocardiographic changes. The procedure is used to evaluate patients for coronary artery spasm as a potential cause of ischemic symptoms.
Service type: Diagnostic cardiovascular provocation test
Typical site of service: Cardiac catheterization laboratory or other monitored cardiac procedure area
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with a history of episodic chest pain and inconclusive noninvasive ischemia testing is referred for invasive evaluation of suspected epicardial coronary artery spasm. The patient undergoes diagnostic coronary angiography under monitored anesthesia care. After baseline angiographic assessment and hemodynamic stabilization, the interventional cardiology team administers incremental intracoronary ergonovine while continuously monitoring for reproduction of chest discomfort and dynamic electrocardiographic changes. Coronary angiograms are obtained during provocation to document focal or diffuse vasoconstriction. The clinical workflow includes pre-procedure informed consent, medication review with temporary discontinuation of nitrates and calcium-channel blockers as indicated, intravenous access and arterial sheath placement, continuous ECG and hemodynamic monitoring, administration of antagonist therapy (e.g., intracoronary nitroglycerin) if spasm occurs, post-procedure observation for reperfusion and arrhythmia, and documentation of findings and management in the procedure report. Typical site of service is an inpatient or outpatient cardiac catheterization laboratory within a hospital or ambulatory surgery center.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician’s professional interpretation or management portion is billed separate from the technical facility resources. |