Cardiology Coding Alert

Question: I know that interpreting an echo without seeing the patient isn’t enough to make the patient established for E/M coding. But what if our office provides the global 93306 performed by a tech?

Codify Subscriber

Answer: Payers will likely count a patient who received a global 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) as established.

CPT® guidelines for E/M state that a new patient “is one who has not received any professional [face-to-face] services from the physician/qualified health care professional or another physician/qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.”

The technical component of 93306 requires face-to-face interaction with a tech supervised by one of your group members.

Additionally, Medicare’s rule is that “an interpretation of a diagnostic test, reading an x-ray or EKG, etc., in the absence of an E/M service or other face-to-face service with the patient does not affect the designation of a new patient,” according to Medicare Claims Processing Manual, Chapter 12, Section 30.6.7 (www.cms.hhs.gov/Manuals/). The statement refers only to the interpretation service as not affecting the patient’s new patient status.