CPT Coding Guidelines Review: Echocardiography

This is a series of blogs about the importance of being familiar with CPT coding guidelines. Often there is extensive guidance preceding a subsection or range of codes for particular procedures, but coders are very busy so sometimes they jump right into the codes without taking time to review these guidelines, even though following or not following their direction could significantly affect the accuracy and comprehensiveness of coding.

This series is designed to help you become familiar with guidelines for significant procedures that you might not be acquainted with but do impact coding. The presentations are short and meant to generate awareness of the guidelines that are available in CPT rather than the application of guidelines to specific coding scenarios.

This installment of the series explores the guidelines related to CPT coding for echocardiography.

CPT Guidelines Echocardiography

Please watch this presentation to learn about the guidelines that provide direction in assigning CPT codes for echocardiography.

Take Aways

• The difference between code 93306 and 93307 is whether spectral and color flow Doppler is used.
• If standard structures are not visualized, the reason why must be documented
• Limited or follow-up studies are usually directed at a focused clinical concern
• A stress echo includes two components, a stress electrocardiogram and a stress echocardiogram
  • CPT has codes specifically for when a complete stress echo is performed or when only some components of a stress echo are provided.
• Transesophageal echocardiograms (TEE) are provided during transcatheter, intracardiac therapies
• TEEs include the work of passing the transducer through the mouth and into the esophagus by the physician performing the TEE
  • If a physician other than the physician performing the TEE inserts the transducer (probe) assign 93313
• Echocardiograms not meeting reporting criteria or without thorough evaluation of organ(s) or anatomic region, image documentation and final written report are not separately reportable

Test Your Knowledge

For detailed explanations of the quiz answers, please refer to the end of this blog post.

Additional Coding Education: Invest in You!

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Quiz Answers and Rationale

Question 1: The answer is 93308. A transthoracic echocardiogram with spectral and color flow Doppler to evaluate performance of a newly place prosthetic valve is a follow-up echo reported with 93308.

Question 2: The answer is passing a transducer into the esophagus. Passing a transducer into the esophagus is part of a transesophageal echocardiogram. The other answer choices are components of a stress echocardiogram.

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The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.