Cardiology Question for the Week of September 21, 2015

Question:

Question:

How would you recommend best capturing 3D echocardiogram complete? Would an unlisted code have to be used to best capture this information?

Answer:

If 3D post-processing is done according to the guidelines and requirements, then one of the following may be assigned along with the appropriate echo code.

76376 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation

76377 requiring image postprocessing on an independent workstation

If this was a complete echo, either 76376 or 76377 would be assigned plus one of the following:

93306 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography

93307 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography

Both 76376 and 76377 require concurrent supervision, which does not mean that the physician has to actually do the reconstructions, but that he must be actively involved in the process. According to the American Medical Association (AMA), concurrent supervision means active participation in and monitoring of the reconstruction process that includes:

1. Design of the anatomic region that is to be reconstructed
2. Determination of the tissue types and actual structures to be displayed (e.g., bone, organs, and vessels)
3. Determination of the images or cine loops that are to be archived
4. Monitoring and adjustment of the 3D work product

Answer: