Cardiology Coding Alert

Question: My cardiologist performed a bubble study with a full echocardiogram. Would I use separate codes for the bubble study and echocardiogram?

New York Subscriber

Answer: No. CPT^® does not offer codes specific to the bubble study. You would report a regular echocardiogram code, and here are some possibilities to choose from (others are possible):

• If the documentation supports the use of color flow and spectral Doppler, opt for 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)
• If the documentation does not support the spectral or color Doppler information, look to 93307 (Echocardiography, transthoracic, real-time with image documentation [2D], includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography)
• For a limited or follow-up echo, choose 93308 (Echocardiography, transthoracic, real-time with image documentation [2D], includes M-mode recording, when performed, follow-up or limited study).

Echocardiograms use high-frequency sound waves to create images of the heart. The cardiologist then uses the images to evaluate the heart's structure to see how well it is functioning.

An echocardiogram with a bubble study (bubble echocardiogram) is actually the same procedure as an echocardiogram, but it does provide additional information. With a bubble echocardiogram, the healthcare provider places an IV in the patient's arm, and agitated saline with bubbles is injected into the vein. This enables the cardiologist to see if there is a tiny hole between the upper chambers of the heart - a patent foramen ovale (PFO) or an atrial septal defect (ASD).