# Coding echocardiogram dx question.



## cevinci (May 21, 2012)

Does anyone know if you perform an echocardiogram on a patient and the reason for ordering the test is dx 401.1 ( hypertension, benign, ) which is not a payable dx according the medicare guidelines, but on the echocardiogram report it states for cardiac rythum the patient is in sinus tachycardia (dx 785.0) which is also a dysrythmia (dx 427.89 (bradycardia or other cardiac dysrthmia). Can I code for this even know it was not mentioned in the previous office visit note, but is documented on the actual echocardiogram report??? Any info would be appreciated. Thanks


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## sophiaz8 (Jun 9, 2012)

I am in Texas and the website we use here is http://www.trailblazerhealth.com. Not all codes will have an LCD but I have found this to be very helpful. 

Depending on what CPT you are using I found the following on the LCD for Medicare indicating the following dx codes are approved for billing:

ICD-9-CM Codes That Support Medical Necessity

The CPT/HCPCS codes included in this LCD will be subjected to “procedure to diagnosis” editing. The following lists include only those diagnoses for which the identified CPT/HCPCS procedures are covered. If a covered diagnosis is not on the claim, the edit will automatically deny the service as not medically necessary.

Medicare is establishing the following limited coverage for CPT/HCPCS codes 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93350, 93351, C8929 and C8930:

Covered for:

074.1
 Epidemic pleurodynia 

074.20–074.23
 Coxsackie carditis 

086.0
 Chagas' disease with heart involvement

088.81
 Lyme disease

093.0
 Aneurysm of aorta specified as syphilitic

093.1
 Syphilitic aortitis

093.20–093.24
 Syphilitic endocarditis 

093.81–093.82
 Other specified cardiovascular syphilis 

093.89
 Other specified cardiovascular syphilis

093.9
 Cardiovascular syphilis unspecified

098.83–098.85
 Gonococcal infection of other specified sites

112.81
 Candidal endocarditis

115.03–115.04
 Infection of Histoplasma capsulatum 

115.13–115.14
 Infection of Histoplasma duboisii 

130.3
 Myocarditis due to toxoplasmosis

135
 Sarcoidosis

164.1
 Malignant neoplasm of heart

164.8
 Malignant neoplasm of other parts of mediastinum

198.89
 Secondary malignant neoplasm of other specified sites

212.7
 Benign neoplasm of heart

238.8–238.9
 Neoplasm of uncertain behavior of other and unspecified sites and tissues

239.89
 Neoplasm of unspecified nature of other specified sites

275.01–275.03
 Disorders of mineral metabolism

275.09
 Other disorders of iron metabolism

276.0–276.4
 Disorders of fluid, electrolyte and acid-base balance

276.50–276.52
 Volume depletion

276.69
 Other fluid overload

276.7–276.9
 Disorders of fluid, electrolyte, and acid-base balance

277.30
 Amyloidosis, unspecified

277.39
 Other amyloidosis

362.30–362.37
 Retinal vascular occlusion 

368.00
 Amblyopia unspecified

391.0–391.2
 Rheumatic fever with heart involvement

391.8–391.9
 Rheumatic fever with heart involvement

392.0
 Rheumatic chorea with heart involvement

393
 Chronic rheumatic pericarditis

394.0–394.2
 Disease of mitral valve

394.9
 Other and unspecified mitral valve diseases

395.0–395.2
 Disease of aortic valve

395.9
 Other and unspecified rheumatic aortic diseases

396.0–396.3
 Diseases of mitral and aortic valves

396.8–396.9
 Diseases of mitral and aortic valves

397.0–397.1
 Diseases of other endocardial structures

397.9
 Rheumatic diseases of endocardium valve unspecified

398.0
 Rheumatic myocarditis

398.90–398.91
 Other and unspecified rheumatic heart diseases

398.99
 Other rheumatic heart diseases

401.0–401.1
 Essential hypertension

401.9
 Unspecified essential hypertension


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