Pulmonology Coding Alert

Question: I often have to bill 93306 for pulmonologists in our practice. What are the payable diagnoses for this procedure?

California Subscriber

Answer: Echocardiography includes getting ultrasonic signals from the heart and great vessels, done with real time image and/or Doppler ultrasonic signal documentation, with its results. Pulmonologists order 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) on a host of diagnoses, including but not limited to:

• 032.82 (Diphtheritic myocarditis)
• 074.21 (Coxsackie pericarditis)
• 074.22 (Coxsackie endocarditis)
• 074.23 (Coxsackie myocarditis)
• 086.0 (Chagas' disease with heart involvement)
• 088.81 (Lyme disease)
• 410.00 - 410.02 (Acute myocardial infarction of  anterolateral wall, episode of care unspecified -- acute myocardial infarction of anterolateral wall, subsequent episode of care)
• 424.0 - 424.3 (Mitral valve disorders -- pulmonary valve disorders).

Most echos are performed in diagnostic testing facilities or cardiology offices where a radiologist or cardiologist will interpret that findings and bill for the services.

Tip: Check out the CMS website (www.cms.hhs.gov) for local coverage determinations (LCD) pertaining to your carrier.