Wiki stress echo/echo

[mom2vanna]

My doctor has performed a stress echo and an echo on the same visit in our office. I would be using 93306 and 93351. I've been putting a modifier on 93306, but should I use one on 93351 also? Or is it better not to do both tests on the same day?

 

[deeva456]

It's not common to perform an echo and a stress echo on the same day unless the echo did not provide the results the md was looking for. If that is the case I would add modifier 59 to 93306 only; not necessary to add it to both 93306 & 93351. However, your documentation should support medical necessity to perform both tests on the same day; more than likely one of these procedures will be denied. Is your doctor routinely doing the echo & stress echo on the same day?

Dolores, CPC- CCC

 

[jerseygirl66]

If anyone has not actually seen a stress echo performed, I highly recommend it. It makes coding much clearer.

A stress echo is basically an echo at rest and then the patient is put on the treadmill and put on a table to echo the heart during excercise. CPT included the rest portion in CPT 93351. See description (bolding is mine)

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 PHYSICIAN SUPERVISION

Rarely should you need to use both 93306 and 93351. Just my two cents.

 

[jerseygirl66]

I should also state that you CAN add the color-flow and Doppler to the 93351 (93325 and 93320) if appropriate.