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Stress or Rest

  1. #1
    Default Stress or Rest
    Medical Coding Books
    Which code set would you use for this note.


    CPT 93306
    or

    CPT 93351,93320,93325





    PROCEDURE:
    The patient underwent 2-D, M-mode and Doppler echocardiography including continuous wave, pulsed wave and color-flow Doppler imaging.

    NORMAL (ADULT) M-MODE VALUE NORMAL RANGE
    LVID at end-diastole: 5.2 cm (3.5-5.6 cm)
    LVID at end-diastole (m2): 2.8 cm/m2 (1.9-3.2 cm/m2)
    LVID at end-systole: 3.4 cm
    SEPTAL THICKNESS: 0.7 cm (0.07-1.1 cm)
    POSTERIOR WALL THICKNESS: 0.8 cm (0.07-1.1 cm)
    AORTIC ROOT: 3.2 cm (2.0-3.7 cm)
    AORTIC ROOT (m2): 1.7 cm/m2 (1.3 to 2.2 cm/m2)
    LEFT ATRIAL SIZE: 3.8 cm (1.9-4.0 cm)
    LEFT ATRIAL SIZE (m2): 2.1 cm/m2 (1.2-2.1 cm/m2)
    EJECTION FRACTION: 65 %
    INTRACARDIAC THROMBUS: Not Present
    PFO/ASD/VSD: No

    DOPPLER MEASUREMENTS:
    AORTIC VALVE PEAK: 12.1 mmHg, MEAN: 1.16 mmHg
    PULMONIC VALVE: 2.7 mmHg.
    Impression/Conclusions
    CSU-020210-17.








    Thank You
    Daniel, CPC


    I'm asking because the physician billed code set CPT 93351,93320,93325. I think this documentation doesn't support these codes because there's no mention of the stress portion being done.

  2. #2
    Default
    Any takers

  3. Default
    The documentation appears to lack documentation significant for...

    "rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress"

    No indication as to whether or not the patient was stressed via Bruce protocol or via pharmacology (Adenosine, Dobutamine etc.)

    Perhaps that the EKG stress portion is documented in a separate report?

    Currently looks more like 93306.

    Hope this helps,
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS
    ciphermed@optonline.net

  4. #4
    Default Pam, CPC
    I also agree with the 93306. No mention of stress echo.

  5. #5
    Default
    I also agree it should be a 93306.

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