# 93306 and 93351



## NESmith (Nov 4, 2011)

Please help. I have a provider who has started doing Echocardiograms for Abnormal EKG and then the next day doing Stress Echocardiograms. the report for the Echo reads:

Indication: Abnormal EKG
2D Doppler Echocardiogram with Color Flow Interpretation:
A 2D Doppler echo with color flow was performed with good technical quality.
M-Mode measurements:
Left Atrium   41  mm                                         RV End diastole      *
Aortic Root   34  mm                                         IVS wall thickness
         11  mm
LV End diastole  54  mm                                    Post wall thickness  
         11  mm
LV End systole   34  mm                                    Ejection Fraction
         60%
2D Echocardiogram Interpertation:
Global left ventricular ijection fraction is normal; calculated 60%. left atrium is dilated. The rest of the cardiac chambers are normal in size. Aortic valve is sclerosed. Mitral valve is slightly thickened. Tricuspid valve appears normal. Pulmonic valve appears normal. Visualized ascending aorta appears unremarkable. Pericardial structures are normal. Inferior vena cava is normal.

Doppler & Color flow Doppler Interpretation:
Aortic valve is normal. Pulmonary valve is normal. Mitral valve has mild regurgitation. Tricuspid valve has mild regurgitation. 

Impression: 
1.  Normal left ventricular ejection fraction.
2.  Mildly dilated left atrium.
3.  Diastolic dysfunction.
4.  No hemodynamically significant valvular abnormalities.
I need an opinion as to whether this would qualify for a Stress Echo the next day. My provider seems to be doing several of these lately which he did not before. Thanks for your help.


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## johnmeyer (Nov 6, 2011)

I'm guessing that your provider wants to see if putting a patient under stress makes the diastolic dysfunction worse. I'm guessing that there are insurance companies that are giving you a hard time about paying for the stress echo after a 2D Doppler Echocardiogram with Color Flow is done.


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