Cardiology Coding Alert
Coding for Dobutamine Stress Echos
Cheryl Agent
Cardiac Care Associates, Crown Point, IN
Answer: The dobutamine stress echos should be billed as follows: 93350 (echocardiography, transthoracic, real-time with image documentation [2D], with or without M-mode recording, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report), 93320 (doppler echocardiography, pulsed wave and/or continuous wave with spectral display [list separately in addition to codes for echocardiographic imaging] complete), and 93325 (doppler echocardiography color flow velocity mapping [list separately in addition to codes for echocardiography]), says Rebecca Sanzone, CPC, assistant billing manager at Midatlantic Cardiovascular Associates in Baltimore, MD. HCPCS code J1250 (injection, dobutamine HCI, per 250 mg) should be used for the dobutamine.
Terry Fletcher, MBA, CPC, CCS-P, president of Physician Reimbursement Solutions, a coding and reimbursement firm in Laguna Beach, CA, urges coders to read their Medicare carrier's newsletter for October 1998, which states that if the physician who referred the patient for the test does not request stress echodoppler, then doppler and color flow (93320 and 93325) cannot be billed.
Medicare attorneys are auditing these claims and if a specific reference to a doppler test is not present, Medicare may demand a refund.
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