Forum - Questions & Answers

Apr 16th, 2009 - jfm2151

Stress Echos in the hospital

We're billing 93350-26, 93016, and 93018 because 93351 "includes the global value of 93015". Does this mean then that the hospital should be using 93350-TC and 93017? Thank you

Apr 16th, 2009 - luannw7     18 

stress echo

We are going through this also. We were billing it that way in 2008. Now with the new code, we are thinking of billing the 993351-TC and either the same as last year for the professional or 993351-26. I too have this question out on other listserves. I hope someone out their can help us!

Apr 16th, 2009 - nmaguire   2,606 

stress Echo

Under the new coding structure, a physician who performs all elements required will report CPT code 93351 However, physicians that do not perform all elements will use CPT code 93350 to report the performance and interpretation of the stress echocardiographic imaging study only with the appropriate components of the cardiovascular stress codes reported separately (93016 - 93018). For example, if a physician does not analyze, interpret and report on the cardiovascular stress test, but does supervise the performance of the stress test along with the stress echo, he/she would report 93350 and 93016.
93350 + 93015 = 93351 (in non-facility setting)
Applicable to a single provider who provides this exam in the office (non-facility) setting.
o Replaces the combined reporting of both codes 93350 and 93015 when done in the office setting.
o Cannot be reported with stress test codes 93015-93018

HOPPS: Two new hospital HCPCS codes (C8929, C8930) were added by CMS to parallel the new 2009 CPT
codes: 93306, combined echo, spectral Doppler with color Doppler and 93351, combined stress test and
stress echo when provided with contrast.

Physician Billing: Stress Echo with Stress Test - In office = 93351

In hospital setting by physician:
93350-26
93016
93018

This may change but for now this is what I go by.
Nancy Maguire

Apr 17th, 2009 - luannw7     18 

stress echo

Nancy,
Thank you for your reply. You mentioned what could be coded on the professional side. How would you code the facility side?

If the physicians are a private group, and they do the supervision, the reveiw, the interpretation of the report do you think a 93351-26 would work? And on the facility side 93351-TC? I was told by a consultant that TC is not needed on a UB because the MAC would automatically realize that it is technical only. However, if the CPT describes the reading, I would think a modifier would be needed. What do you think?
Thanks for your time.

Apr 17th, 2009 - nmaguire   2,606 

stress echo - facility outpatient billing

Hospitals billing under OPPS are instructed to bill for echocardiograms with contrast or without contrast, followed by contrast studies, using the applicable HCPCS code(s) below. They should also report the appropriate units of HCPCS codes for the contrast agents used in the performance of the echocardiograms. Private Carriers may or may not recognize the C codes.

C8928
TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), WITH OR WITHOUT M-MODE RECORDING, DURING REST AND CARDIOVASCULAR STRESS TEST USING TREADMILL, BICYCLE EXERCISE AND/OR PHARMACOLOGICALLY INDUCED STRESS, WITH INTERPRETATION AND REPORT

C8930
TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOVASCULAR STRESS TEST USING TREADMILL, BICYCLE EXERCISE AND/OR PHARMACOLOGICALLY INDUCED STRESS, WITH INTERPRETATION AND REPORT; INCLUDING PERFORMANCE OF CONTINUOUS ELECTROCARDIOGRAPHIC MONITORING, WITH PHYSICIAN SUPERVISION



Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association