TCOM coding (U.S. ICD-9 for CMS)
I have been reviewing coding integrity and have come against a roadblock as to whether a normobaric TCOM with an oxygen challenge and/or an in-chamber TCOM on 100% oxygen meet the requirements for 93923 as a "provocative maneuver."
Historically we have taken it to count, but all examples in coding books available to us use physical exercise examples such as toe elevations or treadmill walking, although they are obviously directing their attention toward ultrasound studies and their examples are neither stated to be exclusive or exhaustive.
The only internet item I've found to specifically address the question is a blog posting from December 2010 by Dick Clarke (http://www.baromedical.com/blog_Dec2010.php) where the question is raised, but there doesn't seem to be a follow up posted.
Does anyone have something in writing from any source stating an answer?