CPT Code for Echocardiogram: What You Need to Know
An echocardiogram is a test that uses sound waves to create images of your heart. It can show how your heart is working, its size and shape, and any problems with its valves, chambers, or blood flow. An echocardiogram can help diagnose and monitor various heart conditions, such as heart failure, heart valve disease, congenital heart defects, and coronary artery disease.
If you have an echocardiogram, you may wonder how it is coded and billed by your doctor or hospital. The answer depends on the type and extent of the echocardiogram you have. There are different codes for different echocardiogram procedures in the Current Procedural Terminology (CPT) system, which is used by healthcare providers and insurers to report and reimburse medical services.
CPT Code for Echocardiogram
The CPT codes for echocardiogram range from 93303 to 93355. They are divided into several categories based on the technique and location of the echocardiogram. Some of the most common categories are:
Transthoracic echocardiography (TTE):
This is the most common type of echocardiogram. It involves placing a device called a transducer on your chest to send and receive sound waves that create images of your heart on a monitor. The CPT codes for TTE are 93303 to 93308, depending on whether the study is complete or limited, and whether it includes Doppler or color flow imaging.
Transesophageal echocardiography (TEE):
This is a more invasive type of echocardiogram that involves inserting a flexible tube with a transducer at its tip into your mouth and down your esophagus (the tube that connects your mouth to your stomach). This allows the transducer to get closer to your heart and produce clearer images. The CPT codes for TEE are 93312 to 93318, depending on whether the study is complete or limited, and whether it includes Doppler or color flow imaging.
Stress echocardiography:
This is a type of echocardiogram that involves performing a TTE or TEE before and after you exercise or receive a medication that makes your heart work harder. This can show how your heart responds to stress and reveal any problems with its blood supply. The CPT codes for stress echocardiography are 93350 to 93352, depending on whether the study is complete or limited, and whether it includes Doppler or color flow imaging.
Fetal echocardiography:
This is a type of echocardiogram that involves performing a TTE on a pregnant woman to examine the heart of her unborn baby. This can detect any congenital heart defects or abnormalities in the baby’s heart development. The CPT codes for fetal echocardiography are 93303 to 93305, depending on whether the study is complete or limited, and whether it includes Doppler or color flow imaging.
Intracardiac echocardiography (ICE):
This is a type of echocardiogram that involves inserting a catheter with a transducer at its tip into a vein in your groin or neck and advancing it into your heart. This can provide detailed images of your heart’s structures and guide certain procedures, such as ablation or device implantation. The CPT code for ICE is 93662.
The CPT codes for echocardiograms may vary depending on the specific circumstances of each case. For example, some codes may be modified by adding modifiers to indicate special situations, such as multiple studies, repeat studies, contrast agents, or professional or technical components. Some codes may also be bundled with other codes to reflect related services.
It is important to understand the CPT codes for an echocardiogram because they affect how much you pay for the test and how much your insurance covers. You should always check with your doctor and your insurance company before having an echocardiogram to verify the code, the cost, and the coverage of the test.
References
(1) CPT® Code 93306 – Echocardiography Procedures – Codify by AAPC.
(2) New 2022 Cardiovascular CPT Codes: A Quick Rundown.
(3) 93306 vs. 93308: Echocardiography – AAPC Knowledge Center.
(4) CPT Codes for Echocardiogram and Echocardiography.
(5) What Is the Echocardiogram CPT Code? A Closer Look – Action Life Media.
FAQs
Q: What is an echocardiogram?
A: An echocardiogram is a test that uses sound waves to create images of your heart. It can show how your heart is working, its size and shape, and any problems with its valves, chambers, or blood flow.
Q: What are the CPT codes for echocardiogram?
A: The CPT codes for echocardiogram are codes that describe the type and extent of the echocardiogram procedure. They range from 93303 to 93355 and are divided into several categories based on the technique and location of the echocardiogram.
Q: How do I know which CPT code to use for my echocardiogram?
A: The CPT code for your echocardiogram depends on the type and extent of the echocardiogram you have. You should check with your doctor or hospital to verify the code, the cost, and the coverage of the test.
Q: How much does an echocardiogram cost?
A: The cost of an echocardiogram varies depending on the type and extent of the echocardiogram, the provider, the location, and your insurance. According to HealthCare Bluebook, a fair price for a complete transthoracic echocardiogram (CPT code 93306) is $1,174. However, this may not include other fees or charges that may apply.
Q: How much does insurance cover for an echocardiogram?
A: The coverage of insurance for an echocardiogram depends on your insurance plan, your deductible, your copay, and your coinsurance. You should check with your insurance company before having an echocardiogram to verify the coverage and the out-of-pocket expenses.
Q: What are some modifiers for echocardiogram codes?
A: Modifiers are codes that indicate special situations or circumstances that affect the coding or reimbursement of a service. Some examples of modifiers for echocardiogram codes are:
– 26: Professional component. This modifier indicates that only the professional service (interpretation and report) was provided by the physician.
– TC: Technical component. This modifier indicates that only the technical service (equipment and personnel) was provided by the facility.
– 59: Distinct procedural service. This modifier indicates that a separate and distinct service was performed on the same day as another service.
– 76: Repeat procedure by the same physician. This modifier indicates that a repeat procedure was performed by the same physician on the same day as another procedure.