Cardiology Coding Alert

Question: Can +93325 for color flow be done without +93320 for spectral when the primary code is 93351? This is an office-based service.

Colorado Subscriber

Answer: From a coding standpoint, you shouldn’t report the code if you aren’t seeing documentation for +93320 (Doppler echocardiography, pulsed wave and/or continuous wave with spectral display [List separately in addition to codes for echocardiographic imaging]; complete).

Although performing both color flow and spectral is typical for a complete echo, you may be encountering a situation where the provider didn’t perform it or perhaps performed it but didn’t document it.

If so, for the case you describe you should report:

• 93351, Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional
• +93325, Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography).

Note: Both codes accept modifier 26 (Professional component), but because you state that the services are office-based, you should not append modifier 26 to either code.