Cardiology Coding Alert

The $88 fee cut makes coding right the first time more crucial than ever.Cardiology coders have been buzzing about a new instruction in CPT 2009's "Echocardiography" section -- you may no longer report your trusty echo code 93307 with spectral (+93320, +93321) and color flow (+93325) Doppler. What does this change mean for you in 2009? Here's what you need to know.Narrow Your Codes From 3 to 1You still will be able to report transthoracic echo with spectral and color flow Doppler in 2009. You just need to change how you report the combined services.2008: For 2008 services, you start by reporting 93307 (Echocardiography, transthoracic, real-time with image documentation [2D] with or without M-mode recording; complete).And you also report add-on codes for the spectral and color flow Doppler, such as both of the following:• +93320 -- Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardio-graphic imaging); complete• +93325 -- Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography).2009: New code 93306 (Echocardiography, transthoracic, real-time with image documentation [2D], includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography) simplifies your coding by combining the services in one code.Key: The new code (93306) includes spectral and color flow Doppler with the transthoracic echo, so you shouldn't report 93306 with Doppler add-on codes +93320-93325, explains Denise Christiansen, CPC, CHC, compliance analyst with Fletcher Allen Health Care in Burlington, Vt.Notes with the spectral and color flow Doppler codes show which codes you may use them with. You can see that 93306 and 93307 are not on the lists:Code Use with ...+93320 93303, 93304, 93312, 93314, 93315, 93317, 93350, 93351+93321 93303, 93304, 93308, 93312, 93314, 93315, 93317, 93350, 93351+93325 76825-76828, 93303, 93304, 93308, 93312, 93314, 93315, 93317, 93350, 93351Keep 93307 for Echo AloneWhen you have a new comprehensive code such as 93306, you also have to be sure you learn how to report the individual elements when performed separately, says Deb Kapernick, advanced coder with Advanced Heart Center in Fort Myers, Fla.For example: You need to know how to report a complete or limited transthoracic echo without spectral and color flow Doppler, says Kapernick.What to do: CPT 2009 keeps echo codes 93307 and 93308, but gives them an update (emphasis added):• 2008: 93307 -- Echocardiography, transthoracic, real-time with image documentation (2D) with or without M-mode recording; complete• 2009: 93307 - Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography• 2008: 93308 -- Echocardiography, transthoracic, real-time with image documentation (2D) with or without M-mode recording; follow-up or limited study• 2009: 93308 --Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, [...]