Cardiology Coding Alert

Question: What are the differences between codes 93306 and 93307?

Florida Subscriber

Answer: The codes you mention are 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) and 93307 (... without spectral or color Doppler echocardiography).

Codes 93306 and 93307 represent a TTE — a non-invasive test that is the most common type of echo. When the cardiologist performs a non-stress TTE for reasons other than congenital heart disease, then you can report 93306 or 93307.

Code 93306: You should report 93306 when the medical documentation supports that the cardiologist performed a complete transthoracic echocardiogram with spectral Doppler and color flow Doppler in addition to 2D and selected M-mode examination (when performed).

Documentation requirements: To report 93306, the medical documentation needs to mention certain structures of the heart and their findings. These structures are the left and right atria, left and right ventricles, the aortic, mitral and tricuspid valves, the pericardium, and the adjacent portions of the aorta. The documentation must also include that the cardiologist performed Doppler/color flow and the findings. Details about the intra cardiac blood flow and hemodynamics are vital, as well.

When reporting 93306, you should document the measurements the cardiologist obtained from the various views of the heart as well as interpretation of those various measurements, including mention that a given value is normal or abnormal, an interpretation of what the abnormal values indicate, not just mentioning abnormal values.

Bonus: When the physician documents velocities, this supports special Doppler and regurgitation supports color flow.

93307: You should report 93307 when the cardiologist performs a 2D and M-mode echo (if done) without performing the spectral or color flow Dopplers.

Documentation requirements: To report 93307, you must have the same documentation details as when reporting 93306, except there would be nothing about spectral Doppler or color flow. You should also document the measurements the cardiologist obtained from the various views of the heart, including the physician’s interpretation of those values being either normal or abnormal and an interpretation of what the abnormal values indicate.

Bottom line: When only one or the other (spectral Doppler or color flow) or both are missing, then you would report 93307.