Wiki Stress echocardiogram in a hospital outpatient setting

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Yuma, AZ
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I have attached a stress echo cardiogram report and need some advice on how to code for stress test/ stress echo/ TEE

These studies have the patient walk on a treadmill and have echo imaging pre and post walking . Another stress echo is a Dobutamine or pharmacologic study. This test has the drug Dobutamine infused and heart is imaged with echo.

If anyone can please route me into the correct way for each exam as this is my first time coding these studies.
Pre-procedure Diagnoses​
1. Dyspnea on exertion [R06.09]​
Procedure:​
Treadmill exercise stress echocardiogram. I have personally supervised the stress test.​
Procedure indication:​
Chest pain, dyspnea
Description of procedure and findings:​

Baseline electrocardiogram demonstrates normal sinus rhythm .


Rest:         HR    88      BP    122/70
Stage I:     HR   145       BP   128/72
Stage II:    HR    167      BP   138/80
Stage III:   HR   186       BP    -
Stage IV:   HR   -       BP   -
Recovery: HR   112        BP    140/80

Symptoms: None.

Electrocardiographic changes: 2 mm ST depressions V3 to V6 during peak stress

Cardiac ectopy: None

Observations: The patient exercised for 8 minutes of a standard Bruce protocol.  2 mm ST depressions V3 to V6 during peak stress. no chest pain.  No arrhythmias.  Patient achieved target heart rate.

Stress echo parameters: Excellent LV function at rest.  Post stress, excellent augmentation of myocardial contractility.  All walls recruit.

Conclusion: Abnormal EKG portion of exercise stress echocardiography.  Normal echo portion exercise stress echocardiography.  Excellent exercise tolerance.  Accelerated heart rate response.​

I have came up with 93350 and 93017.

Thank you!!​
 
Are you billing for the hospital or the provider in the OP setting? If you are coding for the provider and he/she signed the report the same day as the supervision, I would code 93351,26.
 
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