# Echo Complete with Doppler color flow documentation requirement



## wankmuka (May 12, 2010)

Can someone please tell me, what documentation I would need to see, if any, in an Echo report, to distinguish the difference between 93306 (with doppler color flow) and 93307 (without)???  I'm new at coding this, and I'm stumped.


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## carolhodge (May 12, 2010)

Usually in a complete echo which is the 93306 the physician will mention that colorflow and doppler were used.  They will usually refer to whether there was any valvular regurgitation such as trace, mild, moderate or severe amout of mitral, aortic, tricuspid or pulmonic regurgitation.  If they don't mention the use of colorflow or doppler, then I would not bill the 93306, I would bill the 93307.


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## deeva456 (May 12, 2010)

I agree with Carol.  Your documentation should support the use of the doppler and doppler color flow. Check out the LCD list with your Medicare carrier, it should indicate what is required on the report or provide a link to the Medicare guidelines on the CMS website.

Dolores, CPC-CCC


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## PEGGYBRYANT (Nov 11, 2011)

deeva456 said:


> I agree with Carol.  Your documentation should support the use of the doppler and doppler color flow. Check out the LCD list with your Medicare carrier, it should indicate what is required on the report or provide a link to the Medicare guidelines on the CMS website.
> 
> Dolores, CPC-CCC


We are having a difficult time trying to convince our Cardiologist the importance of clearly documenting the doppler and doppler color flow.  He feels if there are measurements documented and mention of diastolic dysfunction and/or regurgitation it is enough.  Any suggestions or guidance for us?  
Thanks
Peggy Bryant, CPC, CCP


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## jewlz0879 (Nov 15, 2011)

PEGGYBRYANT said:


> We are having a difficult time trying to convince our Cardiologist the importance of clearly documenting the doppler and doppler color flow.  He feels if there are measurements documented and mention of diastolic dysfunction and/or regurgitation it is enough.  Any suggestions or guidance for us?
> Thanks
> Peggy Bryant, CPC, CCP



I think if he is documenting that, it would be sufficient. 

Doppler: Measurements of intra-cardiac and/or pulmonary pressures; blood flow velocities. 

Color-Flow: Overall illustration of blood flow by doppler and identifies septal defects, stenosis, shunts, regurgitation. 

So if he is mentions in his findings measurements and diastolic dysfuntion along with what valve(s) have stenosis, regurgitation and ect then that would be sufficient.


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## theresa.dix@tennova.com (Nov 16, 2011)

jewlz0879 said:


> I think if he is documenting that, it would be sufficient.
> 
> Doppler: Measurements of intra-cardiac and/or pulmonary pressures; blood flow velocities.
> 
> ...




Well id have to disagree on this.I believe that the word Doppler and Color flow should be documented in order to bill for it. Even tho Doppler and Color flow go hand in hand they are recognized by two separate add on codes.The color flow is a visual assessment and does not produce numeric measurments.So how would we know it was done for sure unless mentioned?


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## Misty Dawn (Nov 16, 2011)

The physician dictation should confirm image documentation OR attempted documentation of the : Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium if all of this are documented as looked at or attemped (could visual because of body habitus or the likes can still count) AND M-mode with color doppler are dictated you should use: 93306 (Complete study with M-mode and Color)

If Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium if all of this are documented as looked at or attemped but only M-mode is dictated then you should only code: 93307 (Complete study with M-mode).

If not all of the areas are dictated (Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium) then you would code:  93308 (Limited or F/U study only) since a complete study was not done.  If M-mode is documented with the limited study then you can use add on code 93321(M-mode); If Color is performed with the limited study you may add on code 93325 (Color).


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## theresa.dix@tennova.com (Nov 17, 2011)

Misty Dawn said:


> The physician dictation should confirm image documentation OR attempted documentation of the : Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium if all of this are documented as looked at or attemped (could visual because of body habitus or the likes can still count) AND M-mode with color doppler are dictated you should use: 93306 (Complete study with M-mode and Color)
> 
> If Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium if all of this are documented as looked at or attemped but only M-mode is dictated then you should only code: 93307 (Complete study with M-mode).
> 
> If not all of the areas are dictated (Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium) then you would code:  93308 (Limited or F/U study only) since a complete study was not done.  If M-mode is documented with the limited study then you can use add on code 93321(M-mode); If Color is performed with the limited study you may add on code 93325 (Color).



 93321 is M mode?


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