Cardiology Question for the Week of July 18, 2016

Cardiology Compliance Question of the Week

Question:

I work for an outpatient department in an acute-care hospital. Is there any difference between the two codes below in regard to the appropriateness for a facility vs. non-facility setting?

93350 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;
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:

The difference is whether continuous EKG monitoring is performed during the test (with direct supervision by a physician or non-physician practitioner [NPP])—except for Medicare which does not allow NPPs to supervise. When coding for the hospital or facility side codes C8928 or C8930 would be used instead of 93350 or 93351 if contrast is used with the stress echocardiogram.

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