Contractor Information
Contractor Name:
Highmark Medicare Services
Contractor Number:
12102, 12202, 12302, 12501, 12301, 12201
Contractor Type:
MAC Part A & B
Article Information
Article Database ID Number
A47806
Article Type
Article
Key Article
No
Article Title
Transthoracic Echocardiography (TTE)
Contractor’s Determination Number
A47806
Primary Geographic Jurisdiction
Pennsylvania, Maryland, District of Columbia, DELAWARE
Original Article Effective Date
07/11/2008
Article Revision Effective Date
08/01/2008
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 |
General 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 Number
A47806
Revision History Explanation
| Date | Article # | Description |
|---|---|---|
08/01/2008 |
A47806 |
Article effective 08/01/2008 for DC Part A, Maryland Part A, and Pennsylvania Part A. Article is now effective for DC Part A and DCMA Part B; Maryland Part A and Maryland Part B; Pennsylvania Part A; and Delaware Part B. |
07/11/2008 |
A47806 |
Article release date. |