Cardiology Coding Alert

Multiple Echos Are Possible-- Here's How Question: My cardiologist performed an echo and then decided to do transesophageal echocardiography (TEE). Can I bill both or just the TEE?
Alabama Subscriber


Answer: If you've got medical necessity to provide the second diagnostic exam, you can code both. First, you should report the echocardiography with: • 93307-26--Echocardiography, transthoracic, real-time with image documentation (2D) with or without M-mode recording; complete; professional component • +93320-26--Doppler echocardiography, pulsed wave and/or continuous wave with spectral display; complete (list separately in addition to codes for echocardiographic imaging); professional component • +93325-26--Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography). Then you should report the transesophageal study as: • 93312-26-59--Echocardiography, transesophageal, real time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report; distinct procedural service • +93320-26-76--Doppler echocardiography, pulsed wave and/or continuous wave with spectral display; complete (list separately in addition to codes for echocardiographic imaging); repeat procedure by same physician • +93325-26-76--Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography). Your carriers may deny the second set of Doppler and color flow CPT codes as duplicates. If you have medical necessity and very good documentation to back up why you are charging a second set of Doppler and color flow CPT codes, you should appeal a denial to receive payment.