Cardiology Coding Alert

Question: Does a CPT code exist for a Doppler that uses optison, an isotope/contrast material? This is sometimes called the optiscan. Should I code for the injection? Which HCPCS code should I use for the optison?


Michigan Subscriber


Answer: For this service, you should report the following components:

the appropriate echo code (93307,Echocardiography, transthoracic, real-time with image documentation [2D] with or without M-mode recording; complete; or 93308, follow-up or limited study)

plus Doppler (+93320,Doppler echocardiography, pulsed wave and/or continuous wave with spectral display; complete [list separately in addition to codes for echocardiographic imaging]); or +93321, follow-up or limited study [list separately in addition to codes for echocardiographic imaging]) 

as well as color flow (+93325, Doppler echocardiography color flow velocity mapping [list separately in addition to codes for echocardiography]). Almost always, the cardiologist provides all of these services during this situation.
 
Keep in mind: The American Medical Association defines a contrast echo as the injection of a small amount of contrast material intravenously during an echocardiography. You could possibly report this injection with 90784 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; intravenous) when the cardiologist uses contrast media for imaging during echocardiography.

Note: Medicare doesn't reimburse 90784 separately. Section 15502(D) of the Medicare Carriers Manual states that you cannot report an E/M service for a visit whose purpose is to provide the patient with an injection. Carriers will not pay 90784 if your cardiologist performed any other Physician Fee Schedule service on the same date.

Also, you can report for the supply of the optison using A9700 (Supply of injectable contrast material for use in echocardiography, per study).