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NOTE: This is a PREVIOUS VERSION. A more current version of this document is available.

Contractor Information

Contractor Name:

Highmark Medicare Services, Inc.

Contractor Number:

12102, 12202, 12302

Contractor Type:

MAC Part A & B

Article Information

Article ID Number

A47806

Article Type

Article

Key Article

No

Article Title

Transthoracic Echocardiography (TTE)

Primary Geographic Jurisdiction

Maryland, District of Columbia, DELAWARE

Original Article Effective Date

07/11/2008

Article Revision Effective Date

N/A

Article Ending Effective Date

N/A

Article Text

Coding Guidelines

The HCPCS/CPT code(s) may be subject to Correct Coding Initiative (CCI) edits. This information does not take precedence over CCI edits. Please refer to CCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare.

All other echocardiography contrast agents not described by Q9955-Q9957 should be reported with code A9700.

Microcavitation is a technique that utilizes agitated saline as a contrast medium to assess cardiac blood flow patterns.  Microcavitation studies may be reported with procedure code 93799 with the narrative “microcavitation study”. The reimbursement for this service includes the infusion, all supplies and the participation of the physician.

Bill Type Codes:

11x

Hospital-inpatient (including Part A)

12x

Hospital-inpatient or home health visits (Part B only)

13x

Hospital-outpatient (HHA-A also) (under OPPS 13X must be used for ASC claims submitted for OPPS payment -- eff. 7/00)

85x

Special facility or ASC surgery-rural primary care hospital (eff 10/94)

Revenue Codes:

0480

Cardiology-general classification

0483

Cardiology-Echocardiology

0636

Drugs requiring specific identification-detailed coding (eff 3/92)

 

 

Coverage Topic

Diagnostic Tests and X-Rays

Coding Information

CPT/HCPCS Codes

Italicized and/or quoted material is excerpted from the American Medical Association, Current Procedural Terminology (CPT) codes. Hospitals should use guidelines and descriptors associated with the applicable Level I CPT code(s) to bill for echocardiograms without contrast.

93303

TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE

93304

TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY

93307

ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING; COMPLETE

93308

ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING; FOLLOW-UP OR LIMITED STUDY

93320

DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING); COMPLETE

93321

DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING); FOLLOW-UP OR LIMITED STUDY (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING)

93325

DOPPLER ECHOCARDIOGRAPHY COLOR FLOW VELOCITY MAPPING (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHY)

A9700

SUPPLY OF INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY

Q9955

INJECTION, PERFLEXANE LIPID MICROSPHERES, PER ML

Q9956

INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML

Q9957

INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML

Hospitals billing under OPPS are instructed to bill for echocardiograms with contrast or without contrast, followed by contrast studies using the applicable HCPCS code(s) below. They should also report the appropriate units of HCPCS codes for the contrast agents used in the performance of the echocardiograms.

C8921

TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE

C8922

TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY

C8923

TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING; COMPLETE

C8924

TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE RECORDING; FOLLOW-UP OR LIMITED STUDY

 

Other Information

Other Comments

Refer to LCD L27536 for more information on TTE.

Refer to LCD L27478 for information on Cardiovascular Stress Testing.

Refer to LCD L27535 for information on Transesophageal Echocardiography (TEE).

Revision History

Revision History Explanation

DateArticle #Description

07/11/2008

A47806

Article release date.

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