# Stress or Rest



## daniel (Feb 3, 2010)

Which code set would you use for this note.


CPT 93306
 or 

CPT 93351,93320,93325





PROCEDURE:
The patient underwent 2-D, M-mode and Doppler echocardiography including continuous wave, pulsed wave and color-flow Doppler imaging.  

NORMAL (ADULT) M-MODE                      VALUE                        NORMAL RANGE        
LVID at end-diastole:                                         5.2  cm                         (3.5-5.6 cm)       
LVID at end-diastole (m2):                                2.8  cm/m2                   (1.9-3.2 cm/m2) 
LVID at end-systole:                                          3.4  cm   
SEPTAL THICKNESS:                                      0.7  cm                          (0.07-1.1 cm) 
POSTERIOR WALL THICKNESS:                 0.8  cm                          (0.07-1.1 cm) 
AORTIC ROOT:                                                3.2  cm                          (2.0-3.7 cm) 
AORTIC ROOT (m2):                                       1.7  cm/m2                   (1.3 to 2.2 cm/m2) 
LEFT ATRIAL SIZE:                                        3.8  cm                         (1.9-4.0 cm) 
LEFT ATRIAL SIZE (m2):                               2.1 cm/m2                    (1.2-2.1 cm/m2) 
EJECTION FRACTION:                                  65 % 
INTRACARDIAC THROMBUS: Not Present 
PFO/ASD/VSD: No 

DOPPLER MEASUREMENTS:
AORTIC VALVE PEAK:   12.1  mmHg,    MEAN: 1.16  mmHg           
  PULMONIC VALVE: 2.7  mmHg.
Impression/Conclusions 
CSU-020210-17.








Thank You
Daniel, CPC


I'm asking because the physician billed code set CPT 93351,93320,93325. I think this documentation doesn't support these codes because there's no mention of the stress portion being done.


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## daniel (Feb 4, 2010)

Any takers


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## ciphermed (Feb 4, 2010)

The documentation appears to lack documentation significant for...

"rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress"

No indication as to whether or not the patient was stressed via Bruce protocol or via pharmacology (Adenosine, Dobutamine etc.)

Perhaps that the EKG stress portion is documented in a separate report?

Currently looks more like 93306.

Hope this helps,


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## pdrgos (Feb 11, 2010)

*Pam, CPC*

I also agree with the 93306. No mention of stress echo.


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## agott (Feb 11, 2010)

I also agree it should be a 93306.


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