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 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 CPT 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 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.