Cardiology Coding Alert

Question: My cardiologist performed a bubble study with a full echocardiogram. Do carriers reimburse this study when performed at the hospital?

New York Subscriber Answer: You would code a bubble study the same as you would code a regular echo done at the hospital, because CPT does not provide a separate code for the bubble study.

A bubble study provides the cardiologist with additional information to a regular echocardiogram and may be done during the transesophageal echocardiogram. The cardiologist injects an agitated saline solution into the patient's vein and follows the solution as it flows through the patient's heart.  

For a full echocardiogram's interpretation components, you should use 93307 (Echocardiography, transthoracic, real-time with image documentation [2D] with or without M-mode recording; complete), +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).

Remember: You should append modifier -26 (Professional component) to these echocardiography codes if the physician performs the procedure in the hospital.

If you're ever unsure about which codes have professional and technical components, refer to the Medicare Physician Fee Schedule.

Procedures that have professional components (modifier -26) and technical components (modifier -TC) will have separate fees listed for the code with -26 and -TC modifiers in addition to the code with no modifier. The code with no modifier is the "global service" code.