# stress echo/echo



## mom2vanna (Sep 30, 2009)

My doctor has performed a stress echo and an echo on the same visit in our office.  I would be using 93306 and 93351.  I've been putting a modifier on 93306, but should I use one on 93351 also?  Or is it better not to do both tests on the same day?


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## deeva456 (Oct 2, 2009)

It's not common to perform an echo and a stress echo on the same day unless the echo did not provide the results the md was looking for. If that is the case I would add modifier 59 to 93306 only; not necessary to add it to both 93306 & 93351. However, your documentation should support medical necessity to perform both tests on the same day; more than likely one of these procedures will be denied. Is your doctor routinely doing the echo & stress echo on the same day?

Dolores, CPC- CCC


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## jerseygirl66 (Oct 3, 2009)

If anyone has not actually seen a stress echo performed, I highly recommend it.  It makes coding much clearer.

A stress echo is basically an echo at rest and then the patient is put on the treadmill and put on a table to echo the heart during excercise.  CPT  included the rest portion in CPT 93351.  See description (bolding is mine)

_ECHOCARDIOGRAPHY, TRANSTHORACIC, 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_

Rarely should you need to use both 93306 and 93351.  Just my two cents.


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## jerseygirl66 (Oct 3, 2009)

I should also state that you CAN add the color-flow and Doppler to the 93351 (93325 and 93320) if appropriate.


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