Wiki ESE without resting echo

[ShelleyJohnson]

The cardiologist I code for just started doing exercise stress echocardiograms without doing a complete resting echo. The echo tech does a quick baseline echo while the patient is at rest (no report is generated) then the tech does the stress echo while patient is on the treadmill.

SUMMARY:
*1. Negative stress echo for ischemia.
*2. Pt had a treadmill test with 1.25mm ST depressions, and peak SBP was 170mm Hg.
*3. Overall negative stress echocardiogram.

PHYSICIAN INTERPRETATION:

Exam Protocol: The patient exercised on a treadmill according to a Bruce protocol.
Patient Performance: The patient exercised for 10 minutes and 0 seconds, achieving 12 METS. The
maximum stage achieved was IV of the Bruce protocol. The patient developed no symptoms during the
stress exam.
2D Echo Findings: There were no stress-induced wall motion abnormalities. This is a negative stress
echo test for ischemia.

The 93551 code specifies during rest and cardiovascular stress test. So if the resting echo is not being done/reported what code should I use? Maybe 93015 and 93308?

Thanks for your input!

 

[ShelleyJohnson]

ESE with Limited resting echo

This turned out to be a simple fix. The baseline/limited echo is being performed but not documented. If it isn't documented it didn't happen! CPT Assistant, July 2014, Volume 24, Issue 7 basically states that there isn't a defined required elements for the echocardiography. As long as the limited is documented we should be good to go.