Wiki Need help coding Transthoracic Echos

brandyleigh23

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I have been using 93306-26 for most of the Transthoracic Echos that I receive. They usually come in the same format. To ensure I AM coding these correctly, can someone clarify how I can determine if the spectral doppler and color flow doppler was performed?

Also, I have 3 reports on the same patient on consecutive days that I am very unsure of:

Day 1- 06/02/2012
TRANSTHORACIC ECHOCARDIOGRAM

INDICATION: pericardial effusion

PERICARDIUM CONCLUSIONS: There is a large pericardial effusion. Compared to 6-1-2012 the pericardial effusion has increased and respiratory variation of mitral inflow velocity is more marked.




Day 2-06/03/2012
TRANSTHORACIC ECHOCARDIOGRAM

INDICATION: aortic dissection r/o peri.eff-limited study

LEFT VENTRICLE: The left ventricle chamber size is moderately dilated. Minld to moderate concentric left ventricular hypertrophy is observed. The estimated ejection fraction is 20-25%

LEFT ATRIUM: the left atrail chamber size is normal

RIGHT VENTRICLE: the right ventricle chamber size is normal

RIGHT ATRIUM: the right atrial cavilty size is normal

AORTIC VALVE: the aortic valve structure is normal. There is moderate to severe aortic regurgitation

MITRAL VALVE: the mitral valve structure appear normal

AORTA: There is severe dilation of the ascending aorta. There is moderate dilation of the aortc root. There is a dissection extending from the aortic root to the descending aorta. Type A Stanford Classification

CONCLUSIONS: There is a dissection extending from the aortic root to descending aorta.
Type A Stanford classification.
There is moderate dilation of the aortic root.
There is severe dilation of ascending aorta.
There is moderate to severe aortic regurgitation.
Mild to moderate concentric left ventricular hypertrophy. Hypertrophy is observed.
The left ventricular chamber size is moderately dilated.
The estimated EF is 20-25%




Day 3-06/04/2012
TRANSTHORACIC ECHOCARDIOGRAM

CONCLUSIONS: This is a limited f/u study after pericardiocentesis which shows moderate pericardial effusion without any tamponade physiology.




I'm not sure what to code for day one, but days two and three I believe should be 93308-26 since it was a limited study.. I appreciate any input on this!
 
Rose M CPC

Brandy, If in the body of the report, usually located in the descritpion of the procedure should indicate what modalities were used, if the report does not indicate that Color flow and doppler were perfored 93306 is not billiable... Please check page 486 of CPT it will also indicate what structures of the heart must be evaluated to bill a complete 93306 or 93307 and or a limited procdure...

From your examples, I would not be using the complete procedure code 93306
 
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