# Coding Stress Echo



## Mohana Prasad (Apr 6, 2011)

Hi:

Can anyone clarify me how stress echo will be coded for physician practice - professional billing. Will it be coded as 93350-26, 93016 & 93018 or will it be coded simply as 93351-26?

Thanks,
N. Mohana Prasad.


----------



## OliviaPrice (Apr 6, 2011)

The coding will depend on who owns the equipment. 

 If the procedure is done in the office and the physician owns the equipment then you would bill 93351-26.

If the procedure is done in the hospital and they will bill for the TC component then you would bill 93350-26, 93018-26, & 93016-26 (as long as the physician documents their personal presence for the duration of the procedure in the report).


----------



## Jess1125 (Apr 7, 2011)

PRICEOR said:


> The coding will depend on who owns the equipment.
> 
> If the procedure is done in the office and the physician owns the equipment then you would bill 93351-26.
> 
> If the procedure is done in the hospital and they will bill for the TC component then you would bill 93350-26, 93018-26, & 93016-26 (as long as the physician documents their personal presence for the duration of the procedure in the report).



The 93018 and 93016 DON'T get modifier -26 put on. The codes themselves are the professional component of a stress test. 

Jessica CPC, CCC


----------



## dclark7 (Apr 8, 2011)

If the test is being done in the office then the only codes you would use are 93351 (no modifiers) plus the add on codes 93320, 93325 if doppler  and color flow are done. 

Doreen, CPC


----------



## OliviaPrice (Apr 11, 2011)

Jess1125 said:


> The 93018 and 93016 DON'T get modifier -26 put on. The codes themselves are the professional component of a stress test.
> 
> Jessica CPC, CCC



Oops....you're absolutely correct!  I got a bit excited


----------



## Lisa Bledsoe (Aug 18, 2011)

*I am over-thinking...plz help!*

If stress echo is done in the hosptial = 93350-26, +93320-26, +93325-26 (if documented) AND 93016, 93018
So, if 93351 (-26) is performed +93320-26, +93325-26 (if documented) and you would NOT code 93016 and 93018 because 93351 specifically states "with physician supervision".  Correct?


----------



## Jess1125 (Aug 19, 2011)

Lisa Curtis said:


> If stress echo is done in the hosptial = 93350-26, +93320-26, +93325-26 (if documented) AND 93016, 93018
> So, if 93351 (-26) is performed +93320-26, +93325-26 (if documented) and you would NOT code 93016 and 93018 because 93351 specifically states "with physician supervision".  Correct?



Correct, if you're doing all the components of the stress test you'd report the 93351 code WITHOUT the stress test codes. (And doppler/color flow if documented)

CPT guidelines underneath 93351 state "Do not report 93351 in conjunction with 93015-93018, 93350)

Jessica CPC, CCC


----------



## Lisa Bledsoe (Aug 19, 2011)

Thank you...it was one of "those days" where I kept going in circles


----------



## CPCCODERII (Aug 22, 2011)

We have been researching the correct codes to use for a stress echo as well.  We were told that if a complete echo was performed, then in addition to the 93350-26 you would also use 93306-26.  Per the WPS M'care website:

http://www.cms.gov/medicare-coverage-database/lcd_attachments/28565_28/l28565_cv026_cbg_10012010.pdf 

it is not medically appropriate to bill these two codes together, unless there is a differential diagnosis.  We also looked in the CPT book, coders desk reference, CPT assistant 2009 and the CPT reference guide for cardio coding 2011.  The CPT assistant states if a complete echo is performed you can bill it separately, and there is no mention of the a different diagnosis.  The CPT reference guide however does not state anything regarding using the 93306-26 in addition to the 93350-26.  SOoooooo confusing!!


----------

