What is the CPT Code for an Echocardiogram?

ICD and CPT are two coding systems used in medical billing. CPT is an abbreviation for Current Procedural Terminology code. CPT codes describe the clinical procedures and diagnostic care provided by a healthcare provider to a patient. ICD is the International Classification of Diseases, which is used for classifying diseases based on their location, severity, and other characteristics.

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The code is a five-digit numeric code developed by the American Medical Association (AMA). The AMA develops new codes several times a year to keep pace with the evolution of healthcare services.

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This blog will outline the CPT codes used in echocardiography, their significance, and what each code represents.

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What is an echocardiogram?

An echocardiogram evaluates cardiac function, detects abnormalities, and diagnoses various heart conditions. Echocardiograms are used widely in cardiac imaging to:-

• Examine the heart’s anatomy
• Determine its overall health

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Using high-frequency sound waves, real-time images of the heart are obtained to assess the:-

• Heart function
• Identify any structural or functional abnormalities
• Monitor treatment progress

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Types of echocardiograms  

Depending on the specific diagnostic requirements, they are:-

• Transthoracic echocardiography (TTE)
• Transoesophageal echocardiography (TEE)
• Stress echocardiography

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They monitor heart function in patients of all ages. The detailed images and information obtained help us decide the course of action and ensure optimal patient care and management of his cardiovascular health.

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What is CPT?

CPT is the language used by providers and payers. It is essential to bill medical services and procedures for reimbursement accurately. It is the medical code used by healthcare providers to describe the procedure and service they have performed.

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CPT, created by the American Medical Association (AMA), aims to standardize the reporting of medical procedures and diagnostic services for both inpatients and outpatients, where each code describes a specific procedure or service.

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The codes are classified into three categories:-

• Category I includes the largest number of codes commonly used by providers to report their services and procedures.
• Category II includes supplemental tracking codes for performance management.
• Category III temporary codes are used to report emerging and experimental services and procedures.

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Transthoracic echocardiogram (TTE) interpretation:-

CPT code 93307 reports a complete interpretation and report of TTE. The code includes a comprehensive analysis of the echocardiogram images, as well as an assessment of cardiac structure and function.

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Doppler echocardiogram interpretation

The CPT code 93320 is used for the complete interpretation and report of the Doppler echo. It includes a comprehensive analysis of the flow pattern, an interpretation of the blood flow velocity results, and the submission of a detailed report.

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Add on CPT codes if Doppler is performed separately:-

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Add-on codes +93320 and +93325 cannot be billed alone. They are used in addition to base codes like 93307 and 93308

A limited echo 93308 and added Doppler is written as 93308+93320+93325 

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Stress test echocardiography

 93350: Echocardiography, TTE, real-time with image documentation. With or without recording during rest and cardiovascular stress tests using a treadmill or pharmacologically induced stress.

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Importance of CPT codes

Incorrect coding can lead to insurance denials or reduced payments, resulting in financial losses for healthcare providers. Hence, accurate codes must be used when billing.

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Code guidelines for echocardiogram

• Document the echocardiogram performed
• Include the findings of the study
• Document any additional procedures performed

By adhering to these guidelines, healthcare providers can accurately code and bill for echocardiogram services, thereby maximizing reimbursement.

Why is following guidelines important?

We must follow the guidelines for:-

• Accurate billing: It ensures the correct CPT code is assigned for the echo procedure
• Reimbursement following established guidelines helps providers receive proper reimbursement for their services.
• Compliance occurs when we adhere to industry standards and regulations, which reduces the risk of audits and penalties.
• Consistent coding enables meaningful data analysis, which helps to track and analyze trends in the echocardiogram procedure.
• Quality improvement contributes to improved quality of care by promoting thorough reporting of findings and evidence to inform decision-making.

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Do’s and Don’ts of Echocardiogram CPT Codes:-

Do’s

• Use specific CPT codes relevant to the procedure being performed. Ensure accurate documentation and billing.
• Use the most recent CPT codes and stay updated on code changes related to echocardiography.
• Be aware of updated CPT codes. Use the most recent codes related to echocardiography.
• Follow the documentation guidelines for each code, including the required elements and the necessary details.
• Ensure writing proper codes for the echo procedure to avoid audits and billing discrepancies.

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Don’ts:-

• Do not use unspecified or generic codes.
• Do not duplicate or overlap codes that cause billing errors and claim denials.
• Do not assume a single code is sufficient for the entire procedure.
• Do not code for services that were not done.
• Do not ignore the importance of proper documentation and record-keeping.

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Conclusion

Providing accurate codes and billing for echocardiograms is essential for healthcare providers to ensure reimbursement for their services. By doing so, they streamline their revenue, maximize reimbursement, and provide quality patient care.