Cardiology Coding Alert

Reader Question:

Apply J7051 for Saline With Bubble Study

Question: When a physician performs an in-office 2-D echocardiogram, should I report the study with contrast or with contrast and bubble study? Which codes should I report? Also, should I use 90784 for the injection and 36000* (Introduction of needle or intracather, vein) for the IV access?

North Carolina Subscriber
Answer: CPT does not provide a separate code for the bubble study, so you would not report the study separately.
 Bubble studies involve injecting agitated saline into the blood to look for problems such as atrial septal defect. You can report J7051 (Sterile saline or water, up to 5 cc) to Medicare, however, for the saline the physician used. For non-Medicare payers, report 90784 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; intravenous) for the injection. You could also bill the appropriate 2-D echocardiogram code (93307-93308) and an E/M code for the visit.