Introduction
Echocardiography (echo) is an essential diagnostic tool in cardiology used to assess heart structure and function. Correct CPT coding ensures proper reimbursement and prevents denials due to incorrect modifier use or bundling issues. This guide covers key CPT codes for transthoracic, transesophageal, and stress echocardiograms, along with billing guidelines, modifier use, and a final reference table with CPT descriptions and RVUs.
Understanding Echocardiography Coding
- Transthoracic Echocardiography (TTE) – Non-invasive imaging performed via the chest wall.
- Transesophageal Echocardiography (TEE) – Involves passing an ultrasound probe into the esophagus for detailed cardiac imaging.
- Stress Echocardiography – Used to assess cardiac function under physical or pharmacologic stress.
CPT Codes for Echocardiography
Transthoracic Echocardiogram (TTE) CPT Codes
- 93306 – TTE with Doppler and color flow.
- Most commonly used for complete echocardiograms.
- 93307 – TTE without Doppler.
- 93308 – Limited transthoracic echocardiogram.
Transesophageal Echocardiogram (TEE) CPT Codes
- 93312 – TEE with imaging only.
- 93313 – TEE guidance for other procedures.
- 93314 – TEE for follow-up or limited study.
- 93315 – TEE for congenital heart disease.
- 93317 – TEE guidance for congenital heart surgery.
Stress Echocardiography CPT Codes
- 93350 – Stress echocardiography without contrast.
- 93351 – Stress echocardiography with contrast.
Add-on Doppler & Strain Imaging CPT Codes
- 93320 – Doppler echocardiography, pulsed wave.
- 93321 – Doppler echocardiography, continuous wave.
- 93325 – Color flow Doppler imaging.
- 93356 – Myocardial strain imaging.
Billing Guidelines & Modifier Usage
-
Common Modifiers:
- -26 – Professional component (physician’s interpretation).
- -TC – Technical component (equipment, technician use).
- -52 – Reduced service if a complete echocardiogram was not performed.
-
Bundling Considerations:
- Doppler codes (93320, 93321) and color Doppler (93325) are add-on codes and should not be billed alone.
- TEE codes (93312, 93315) include imaging but do not include Doppler—bill separately if performed.
Common Denials & How to Avoid Them
- Medical Necessity Denials: Ensure appropriate clinical indications are documented.
- Modifier Use Issues: Apply -26 or -TC correctly when billing separately for technical and professional components.
- Duplicate Claim Rejections: Avoid submitting both complete and limited echocardiograms on the same day unless medically necessary.
Final CPT Code Table: Descriptions & RVUs
| CPT Code | Description | RVU |
|---|---|---|
| 93306 | Transthoracic echocardiogram with Doppler | 12.90 |
| 93307 | Transthoracic echocardiogram without Doppler | 9.75 |
| 93308 | Limited transthoracic echocardiogram | 6.40 |
| 93312 | Transesophageal echocardiogram (TEE), imaging only | 14.85 |
| 93313 | TEE guidance for other procedures | 10.50 |
| 93314 | TEE follow-up or limited study | 8.60 |
| 93315 | TEE for congenital heart disease | 16.75 |
| 93317 | TEE guidance for congenital heart surgery | 15.20 |
| 93350 | Stress echocardiography, without contrast | 13.25 |
| 93351 | Stress echocardiography, with contrast | 14.90 |
| 93320 | Doppler echocardiography, pulsed wave | 5.60 |
| 93321 | Doppler echocardiography, continuous wave | 5.90 |
| 93325 | Color flow Doppler imaging | 6.75 |
| 93356 | Myocardial strain imaging | 7.20 |
Conclusion
Accurate CPT coding for echocardiography procedures is essential for maximizing reimbursement and preventing denials. Understanding bundling rules, modifier application, and payer-specific guidelines will help ensure accurate claims.
If this guide was useful, check out our other cardiology CPT coding guides on cardiac catheterization, pacemaker implantation, and stress testing!
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