# 2009 Echo, Stress Echo, Limited Echo Codes



## laurap (Jan 14, 2009)

Can someone please help me? I am new to cardiology coding and I just want to make sure I am sending our claims out correctly.

*Is this the correct way to code the following for 2009?

*Complete Echo*
_Office_ - 93306
_Hospital _- 93306 w/ modifier 26

*Follow-Up or Limited Echo*
_Office_ - 93308
            + 93321 (If Spectral Doppler was used)
            + 93325 (If Color Flow Doppler was used)

_Hospital_ - 93308 w/ modifier 26
               + 93321 (If Spectral Doppler was used)
               + 93325 (If Color Flow Doppler was used)
* In this case do 93321 and 93325 require a modifier 26 also?

*Stress Echo*
_Office_ - 93351
            + 93352 (When contrast agent is used)
            + Applicable Drug Code (When contrast agent is used)

_Hospital_ - 93350 w/ modifier 26
               + 93016
               + 93018
* In this case if a contrast agent is used, but supplied by the hospital should I bill 93352 also?

Plus, the following should be coded the same as in 2008:

Stress Test Alone
TEE
Adenoscan
Nuclear Stress Test
Exercise Tolerance Test

Please let me know the answers to the questions above. Thank you.

Laura L. Porter, CPC
Jamestown Area Medical Associates
15 South Main Street
Suite 300
Jamestown, NY 14701
(716) 488-1877 ext 2006


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## jerseygirl66 (Jan 14, 2009)

All is correct.  Regarding the questions in red:

Hospital - 93308 w/ modifier 26
+ 93321 (If Spectral Doppler was used)
+ 93325 (If Color Flow Doppler was used)
* In this case do 93321 and 93325 require a modifier 26 also?
*
Yes, use 26 in a hospital setting for the 93321 and 93325
*

Hospital - 93350 w/ modifier 26
+ 93016
+ 93018
* In this case if a contrast agent is used, but supplied by the hospital should I bill 93352 also?

*Yes, the 93352 was created to reflect the time administering/supervising the contrast injection in both the office and hospital setting.  No modifier needed.  The hospital bills the supply*

Everything else looks A OK.


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## laurap (Jan 15, 2009)

Thank you for your help, I really appreciate it.

I have one more question.

When billing for a TEE at the hospital I use the following:

93312 w/ modifier 26
+93320
+93325

Should I also be appending a modifier 26 to 93320 and 93325?

Please let me know. Thank you.

Laura L. Porter, CPC
Jamestown Area Medical Associates
15 South Main Street
Suite 300
Jamestown, NY 14701
(716) 488-1877 ext 2006


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## laurap (Jan 15, 2009)

Nevermind. I just figured it out. There should be a modifier 26 on them. Thank you again for your help.

Laura L. Porter, CPC
Jamestown Area Medical Associates
15 South Main Street
Jamestown, NY 14701
(716) 488-1877 ext 2006


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## SDalzell (Jan 16, 2009)

*Cpc*

Based on our Custom Coder software 93320 is bundled with 93325.


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## jerseygirl66 (Jan 20, 2009)

SDalzell said:


> Based on our Custom Coder software 93320 is bundled with 93325.



Per CCI edits (and experience), 93320 and 93325 are not bundled.  I would question this with your software vendor.


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## edithkballard (Jan 22, 2009)

There's still is a good bit of discussion about the use of code 93351. CMS has established the code with APC status indicator "S" payable under HOPPS. I've emailed the FI(Trailblazer) to see if they had better clarification on this code. Just a FYI.


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## SDalzell (Jan 27, 2009)

It states 93325 is a component of 93320. It's a new edit this year.


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## laurap (Jul 1, 2009)

*CPT 93352 Denials*



> * In this case if a contrast agent is used, but supplied by the hospital should I bill 93352 also?
> 
> Yes, the 93352 was created to reflect the time administering/supervising the contrast injection in both the office and hospital setting. No modifier needed. The hospital bills the supply



Please help!

Has anyone been having trouble with CPT 93352 being denied?

I work for a multispecialty physicians group and I do the cardiology billing. I know that the hospital cannot bill this code; however, after my original post and the reply (which I have inserted above), I was under the impression that we could bill CPT 93352 for the physician even if the test was done at the hospital.

For the first few months we did not have any problems, but now we are receiving denials. Does anyone know of a web site I can visit that will give me clarification on this and/or does anyone have any information that might help me?

Please let me know.

Thank you,

Laura L. Porter, CPC
Jamestown Area Medical Associates


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