Cardiology Coding Alert

Question: Should our office code an in-office echo performed with our equipment as 93306 as the initial code along with 93306-TC, or would the correct billing be 93306-26 along with 93306-TC?

Pennsylvania Subscriber

Answer: In general, you should be able to report an in-office 93306 (Echocardiography, transthoracic,real-time with image documentation [2D] includes Mmode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography) service without needing to use modifier 26 (Professional component) or TC (Technical component). The global 93306 without these modifiers covers both services.

Caution: If your payer requires you to report each component on the day the provider performs it, you typically will report 93306-TC for the date the provider performs the echo and 93306-26 for the date the cardiologist interprets the data.

Prepare yourself: Be aware that some payers deny the second echo claim when submitted in this manner (separate dates) because they have edits to prevent overutilization of imaging services that dont adjust for billing the two test components separately.

For example, some payers only reimburse one echo in any six month period. If you submit 93306-TC on Monday (the day the team acquires the images) and then submit 93306-26 on Tuesday (the day the doctor interpreted) some payers will deny the 93306-26 based on overutilization.