93306 vs. 93308: Echocardiography

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:

    • LV
    • RV
    • LA
    • RA
    • mitral, aortic, tricuspid valves
    • pericardium
    • 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.

John Verhovshek
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About Has 584 Posts

John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.

7 Responses to “93306 vs. 93308: Echocardiography”

  1. Christina says:

    Thanks for the complete description of a full echo.

  2. Dede says:

    if i have an echo report with only the lv, av, mv and pericardium with measurements for Diastolic/Systolic Function, Aortic Valve and Mitral Valve would this be a 93308?

  3. Sankarkumar Venkatasubramanian says:

    It does include the EF also, right?

  4. Stacy Diehl says:

    What if the technical portion was a complete 93306 and during the interpretation, there is a statement image quality is not good enough to comment on the segmental wall motion abnormality but all the anatomy required is in the report? Do you bill a complete or limited?
    OR there was mention of all the anatomy in the report but a statement the study was technically limited due to poor patient compliance? Do you bill a limited or complete?
    The attempt was made in both instances

  5. Heather Hall says:

    If one of the complete 2D/M-mode elements listed above is missing but all elements of the Doppler are performed (all cardiac valves and the septa) should we report 93321 instead of 93320 as 93320 is not to be reported with parent code 93308?

  6. Dede says:

    yes the report does include the EF.

  7. sadhana says:

    Hello, Can someone tell me to bill 93306 do we need a documented report or will the images alone be sufficient.