# New 2009 Stress Echo codes



## aforsythe (Nov 20, 2008)

I am wondering if any one has reviewed the new echo codes, I have a question on billing the stress echo interps in the hospital.  We bill a 9335026, 93018, and 93016 for a stress echo in the hospital now.  With the new code; according to the Medicare fee schedule, it appears that we will not be able to add the 26 modifier on 93351.  I am wondering how other groups are going to bill stress echo interps?  I am good with all the other new codes, I think we might be questioning ourselves to much with the stress echo codes.


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## luvsgoofey (Nov 26, 2008)

*Stress Echo Interps*

Hello

Our office does the interps and this has begun a major dicussion because at this time it appears we are going to be losing a large sum of money when the new codes come into effect.  I am having a meeting first week of December to get concrete explanations.  
So, I will forward the findings on to you when I get them.  I hope this helps.


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## aforsythe (Nov 28, 2008)

Thanks so much!!!  We look at the codes everyday and question if we are going to be billing them correctly because of the big change in reimbursement.


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## lcterry (Dec 6, 2008)

I recently attended an advanced cardiology coding seminar and the 93550 is billed when one physician reads the echo portion and a different physician reads the stress portion this would be used more for hospital readings.  93551
is used when the same physician reads the stress and echo portion of the exam.

Hope this helps.


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## aforsythe (Dec 8, 2008)

Thank You!


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## jerseygirl66 (Dec 8, 2008)

I have to disagree.  93351 does not have a separate fee for technical or professional component (26 or TC).  According to the AMA, you would only use 93351 for global, where you own the equipment. 93350 should continue to be used in a hospital setting.


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## lcterry (Dec 10, 2008)

I believe that is what I was trying to convey in my previous response, that 93550 would be used _more_ for hospital readings. You could use this in the office as well.  You would use the 93550 for the physician performing the echo portion and  93015 for the physician performing the stress portion.

93551 would be used in the office when you have one physician performing the stress portion and the echo portion.

I hope I explained that a little better this time.  I will not get into any arguments with anyone over this.  I feel coders sometimes start arguing about coding interpretations, and that should not be done.

Coding at times is based on each person's interpretation, especially when codes are not clear cut.

Thanks,

Colette


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## jerseygirl66 (Dec 14, 2008)

No worries, wasn't trying to argue.  Just stating my interpretation.  Things are often misunderstood when it is written as opposed to verbal.


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## PMurphy28 (Dec 17, 2008)

*93351*

 we are a private mds office and own equipement.  currently we bill 93350 & 93015.  do we have to bill 93351 rather than 93350 & 93015 or do we have to start billing 93351? Thank you in advance!


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## dabeall (Dec 17, 2008)

*93306 vs 93307/93320/93325*

I am also wondering about the code 93306.  I have been reading all the info on the new code that looks like it will replace the codes 93307/93325/93320. I have spoke with seneral of my physicians and they all agree that the way it was written it will peplace 93307/93320/93325 and if that is true Medicare is only going to pay less that a hundred dollars for this test.  if that is true our doctors office will lose a considerable amount of money and I don't want to tell my physician this because he is already stressing about money.


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## efrohna (Dec 18, 2008)

PMurphy28 said:


> we are a private mds office and own equipement.  currently we bill 93350 & 93015.  do we have to bill 93351 rather than 93350 & 93015 or do we have to start billing 93351? Thank you in advance!




PMurphy, Yes.  Effective 1/1/09 you will report 93351 alone since it includes 93015 and 93350.  

This is my question, we do not own the equipment for the stress echo only
(93350), so we would report 93350(26), 93016, 93017, and 93018.  Am I correct?


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## jerseygirl66 (Dec 18, 2008)

Yes 93306 for 2009 now encompasses 93307, 93325 and 93320 into one code.  and YES, a decrease in reimbursement occurred as well (about 25%!).

93351 for 2009 includes 93015 and 93350 if you are billing globally in the office for the entire test performed by one physician.  You would continue to use 93350 and 93015 if one doctor is interpreting the echo and another is interpreting the stress portion, although I am unsure if upcoming CCI edits may preclude this-- we'll have to wait and see.

For hospital testing interps:  You would continue to use 93350-26, 93016, 93018.


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