Cardiology Coding Alert

Question: What are explosion codes, and should we use them?

Tennessee Subscriber Answer: Explosion codes pertain to when your computer system automatically adds the commonly billed add-on codes to your primary code. The most common are echocardiography codes.

For example, when you key in 93307 (Echocardiography, transthoracic, real-time with image documentation [2D] with or without M-mode recording; complete), your computer system will add +93320 (Doppler echocardiography, pulsed wave and/or continuous wave with spectral display [list separately in addition to codes for echocardiographic imaging]; complete) and +93325 (Doppler echocardiography color flow velocity mapping [list separately in addition to codes for echocardiography]).

Caution: This can be a compliance issue. You need to be certain your cardiologist actually performed these services. Don't forget to include ICD-9 codes drawn from your cardiologist's documentation that support these codes.

Example: If the patient has an additional heart problem along with the underlying condition that led to a transthoracic echocardiography (99307), you can use the other condition as justification for the Doppler. For example, the physician orders a TTE for an alcoholic patient with benign hypertension and heart failure (402.11). But the patient also has shortness of breath (786.05), and because the physician suspects alcoholic cardiomyopathy (425.5), he orders a Doppler study (93320) and color flow mapping (93325).

When coding this scenario, you should use 93307, 93320 and 93325. Don't rely on the explosion codes alone. You must link 402.11 to 93307, and 786.05 to 93320 and 93325.