Cardiology Coding Alert

Question: My cardiologist wants to perform a bi-ventricular optimization echo interrogation with programming in the office. Should we use 93799 for this procedure?


Kansas Subscriber


Answer: Instead of 93799 (Unlisted cardiovascular service or procedure), many practices are using the limited echo code 93308 (Echocardiography, transthoracic, real-time with image documentation [2D] with or without M-mode recording; follow-up or limited study).
 
Cardiologists typically use Doppler to conduct echo optimization, which you would report using one of the following codes:

+93320 - Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete

+93321 - ... follow-up or limited study (list separately in addition to codes for echocardiographic imaging). Your cardiologist may also perform a color flow, which you would report using +93325 (Doppler echocardiography color flow velocity mapping [list separately in addition to codes for echocardiography]). In order to know the correct codes to use, you need to be sure exactly what kind of echo your cardiologist performs, because sometimes this can be a full echo.
 
You'll mostly find that the procedure is limited, however. For the appropriate pacer/ICD check code, you should report one of the following two codes:
93744 - Electronic analysis of pacing cardioverter-defibrillator (includes interrogation, evaluation of pulse generator status, evaluation of programmable parameters at rest and during activity where applicable, using electrocardiographic recording and interpretation of recordings at rest and during exercise, analysis of event makers and device response); dual chamber, with reprogramming

93732 - Electronic analysis of dual-chamber pacemaker system (includes evaluation of programmable parameters at rest and during activity where applicable, using electrocardiographic recording and interpretation of recordings at rest and during exercise, analysis of event markers and device response); with reprogramming. You should report one of these codes because the cardiologist performs this service on the same day. Choose a code depending on whether the biventricular device is a defibrillator or pacemaker.