Cardiology Coding Alert

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 A4216 (Sterile water, saline, diluent/flush 10 ml) to Medicare for the saline the physician used.

For non-Medicare payers, report 90774 (Therapeutic, prophylactic or diagnostic injection [specify substance or drug]; intravenous push, single or initial substance/drug) for the injection. You could also bill the appropriate 2-D echocardiogram code (93307-93308) as well as Doppler and color flow studies (93320 and 93325) if performed and documented.