Cardiology Coding Alert

Question: The descriptor of 93350 says the cardiologist does the echocardiography during the stress treadmill (or pharmacologic-induced stress), with interpretation and report. Yet, at my practice, the cardiologist does the echocardiography with isotopes before the treadmill and after, not actually during the stress treadmill test. Am I correct in report 93350?

Florida Subscriber Answer: You may be confusing 93350 (Echocardiography, transthoracic, real-time with image documentation [2D], with or without M-mode recording, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report) with myocardial perfusion imaging (78465, Myocardial perfusion imaging; tomographic [SPECT], multiple studies, at rest and/or stress [exercise and/or pharmacologic] and redistribution and/or rest injection, with or without quantification).
 
You should use 93350 for the echocardiography the cardiologist performs during and immediately following the stress test. You should use 78465 for a myocardial perfusion study (frequently called "SPECT").