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Echo Complete with Doppler color flow documentation requirement

  1. #1
    Default Echo Complete with Doppler color flow documentation requirement
    Medical Coding Books
    Can someone please tell me, what documentation I would need to see, if any, in an Echo report, to distinguish the difference between 93306 (with doppler color flow) and 93307 (without)??? I'm new at coding this, and I'm stumped.

  2. #2
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    Usually in a complete echo which is the 93306 the physician will mention that colorflow and doppler were used. They will usually refer to whether there was any valvular regurgitation such as trace, mild, moderate or severe amout of mitral, aortic, tricuspid or pulmonic regurgitation. If they don't mention the use of colorflow or doppler, then I would not bill the 93306, I would bill the 93307.

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    I agree with Carol. Your documentation should support the use of the doppler and doppler color flow. Check out the LCD list with your Medicare carrier, it should indicate what is required on the report or provide a link to the Medicare guidelines on the CMS website.

    Dolores, CPC-CCC

  4. #4
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    Quote Originally Posted by deeva456 View Post
    I agree with Carol. Your documentation should support the use of the doppler and doppler color flow. Check out the LCD list with your Medicare carrier, it should indicate what is required on the report or provide a link to the Medicare guidelines on the CMS website.

    Dolores, CPC-CCC
    We are having a difficult time trying to convince our Cardiologist the importance of clearly documenting the doppler and doppler color flow. He feels if there are measurements documented and mention of diastolic dysfunction and/or regurgitation it is enough. Any suggestions or guidance for us?
    Thanks
    Peggy Bryant, CPC, CCP

  5. #5
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    Quote Originally Posted by PEGGYBRYANT View Post
    We are having a difficult time trying to convince our Cardiologist the importance of clearly documenting the doppler and doppler color flow. He feels if there are measurements documented and mention of diastolic dysfunction and/or regurgitation it is enough. Any suggestions or guidance for us?
    Thanks
    Peggy Bryant, CPC, CCP
    I think if he is documenting that, it would be sufficient.

    Doppler: Measurements of intra-cardiac and/or pulmonary pressures; blood flow velocities.

    Color-Flow: Overall illustration of blood flow by doppler and identifies septal defects, stenosis, shunts, regurgitation.

    So if he is mentions in his findings measurements and diastolic dysfuntion along with what valve(s) have stenosis, regurgitation and ect then that would be sufficient.
    Julie Graham, BA, CPC, CCC

  6. Default
    Quote Originally Posted by jewlz0879 View Post
    I think if he is documenting that, it would be sufficient.

    Doppler: Measurements of intra-cardiac and/or pulmonary pressures; blood flow velocities.

    Color-Flow: Overall illustration of blood flow by doppler and identifies septal defects, stenosis, shunts, regurgitation.

    So if he is mentions in his findings measurements and diastolic dysfuntion along with what valve(s) have stenosis, regurgitation and ect then that would be sufficient.

    Well id have to disagree on this.I believe that the word Doppler and Color flow should be documented in order to bill for it. Even tho Doppler and Color flow go hand in hand they are recognized by two separate add on codes.The color flow is a visual assessment and does not produce numeric measurments.So how would we know it was done for sure unless mentioned?
    Theresa CCS-P CPMA CCC ICDCT-CM

  7. #7
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    The physician dictation should confirm image documentation OR attempted documentation of the : Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium if all of this are documented as looked at or attemped (could visual because of body habitus or the likes can still count) AND M-mode with color doppler are dictated you should use: 93306 (Complete study with M-mode and Color)

    If Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium if all of this are documented as looked at or attemped but only M-mode is dictated then you should only code: 93307 (Complete study with M-mode).

    If not all of the areas are dictated (Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium) then you would code: 93308 (Limited or F/U study only) since a complete study was not done. If M-mode is documented with the limited study then you can use add on code 93321(M-mode); If Color is performed with the limited study you may add on code 93325 (Color).

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    Quote Originally Posted by Misty Dawn View Post
    The physician dictation should confirm image documentation OR attempted documentation of the : Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium if all of this are documented as looked at or attemped (could visual because of body habitus or the likes can still count) AND M-mode with color doppler are dictated you should use: 93306 (Complete study with M-mode and Color)

    If Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium if all of this are documented as looked at or attemped but only M-mode is dictated then you should only code: 93307 (Complete study with M-mode).

    If not all of the areas are dictated (Left and right atria, Left and right ventricles, aortic, tricuspid & mitral valves, pericardium) then you would code: 93308 (Limited or F/U study only) since a complete study was not done. If M-mode is documented with the limited study then you can use add on code 93321(M-mode); If Color is performed with the limited study you may add on code 93325 (Color).
    93321 is M mode?
    Theresa CCS-P CPMA CCC ICDCT-CM

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