93306 vs. 93308: Echocardiography
When reporting echocardiography, you must be careful to differentiate complete (93306) vs. limited or follow-up studies (93308).
Complete Study: 93306
Code 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 describes a complete transthoracic echo with Doppler and color flow. The following documented information is needed to report a complete echo:
- mitral, aortic, tricuspid valves
- adjacent portion of the aorta
CPT® criteria explain:
… a complete transthoracic echocardiogram requires 2-dimensional and, when performed, selected M-mode examination of the left and right atria, left and right ventricles, the aortic, mitral and tricuspid valves, the pericardium and adjacent portions of the aorta. (Note that while M-mode exam is usually performed, it is not required in order to assign a complete echo code.) If it is impossible to image all of the listed structures, the report must indicate the reason. A limited transthoracic echocardiogram should be billed if the report does not evaluate or attempt to evaluate all of the structures listed above.
Limited or Follow-up Study: 99308
A follow-up or limited echo study, 93308 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study does not evaluate (or document the attempt to evaluate) all the structures that comprise the complete echocardiographic exam, as outlined in the CPT® criteria, above. A limited study is typically confined to, or performed in follow-up of, a focused clinical concern.
CPT Assistant (September 2005) further advises:
[echo] whether complete or limited, includes an interpretation of all obtained information, documentation of all clinically relevant findings including quantitative measurements obtained, plus a description of any recognized abnormalities. Pertinent images, videotape, and/or digital data are archived for permanent storage and are available for subsequent review. Use of echocardiography not meeting these criteria is not separately reportable.