Anesthesia Coding Alert

Question: I've heard different interpretations regarding certification guidelines for an anesthesiologist doing echocardiography. Some sources say the anesthesiologist has to be certified through the facility that where he is working. I've also heard he has to have some form of national certification. Does the anesthesiologist have to be certified to do the procedure? And if he performs the exam, what codes would I use?

Iowa Subscriber

Answer: Assuming your physician is credentialed to perform an echocardiography procedure, you might use 93312 (Echocardiography, transesophageal, real-time with image documentation [2D] [with or without M-mode recording]; including probe placement, image acquisition, interpretation and report), and use the crosswalk anesthesia code 01922 (Anesthesia for non-invasive imaging or radiation therapy).

Physicians and nurses have a "Delineation of Privileges" that outlines what procedures they are allowed to perform in facilities and/or offices based on training and skills. This is part of their credentialing process.

In order to determine if your anesthesiologist must be credentialed before performing the procedure, you'll need to check your hospital guidelines, and also check with your payers. There is no law requiring certification, but most hospitals require some training in echocardiography before credentialing a physician to use it.

Several payers, including United Healthcare, also require some form of credentialing in order to reimburse services like those covered by 93312.

The American Society of Echocardiography has published papers on the subject of credentialing, and offers the following: "A new cardiac sonographer entering the field must comply with the formal educational requirements specified by the applicable credentialing organization, and must fulfill those requirements through participation in a program recognized by the ASE." For more information from the ASE, visit www.asefiles.org/sonographerminimumstandards.pdf.