Ultrasound Question for the Week of June 27, 2016

Question:

Question:

If a patient is seen in the hospital outpatient department for a stress echocardiogram, can the hospital bill the following code and the physician bill it with modifier -26 (professional component) appended?

93351

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 supervision by a physician or other qualified health care professional

Answer:

Answer:

If a stress echocardiogram is performed with continuous electrocardiographic (EKG) monitoring, the answer is yes, the hospital can assign code 93351 (technical component). The physician who supervises the stress test and interprets the stress echocardiogram would report the code with modifier -26 (professional component).

If different physicians perform the supervision and interpretation, the following codes would be reported by the appropriate physicians.

93350-26

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;

93016

Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report

93018

Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only