How To Use CPT Code 93303

CPT 93303 is a code for complete transthoracic echocardiography for congenital cardiac anomalies. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93303 procedures.

1. What is CPT 93303?

CPT 93303 is a medical billing code used to describe a complete transthoracic echocardiography procedure performed on patients with congenital cardiac anomalies. This diagnostic test involves obtaining images of the heart structures through the chest wall to evaluate the presence and severity of congenital heart defects. The procedure is essential for diagnosing and managing patients with congenital heart conditions.

2. 93303 CPT code description

The official description of CPT code 93303 is: “Transthoracic echocardiography for congenital cardiac anomalies; complete.”

3. Procedure

The 93303 procedure involves the following steps:

1. The patient is appropriately prepped, and a gel is applied to the chest wall.
2. A small transducer is placed on the chest wall, generating high-frequency sound waves that bounce off the heart back to the probe.
3. The probe is connected to a monitor that displays images of the heart structures.
4. The provider moves the probe in different directions on the chest to obtain images of the heart, including subcostal, apical, parasternal, and suprasternal views.
5. The provider examines the heart’s movement, blood flow through various blood vessels and valves, and evaluates any congenital abnormalities.

4. Qualifying circumstances

Patients eligible to receive CPT code 93303 services are those with suspected or confirmed congenital cardiac anomalies. These may include patients with a family history of congenital heart defects, those presenting with signs and symptoms suggestive of a congenital heart condition, or patients with an abnormal finding on a previous cardiac imaging study.

5. When to use CPT code 93303

It is appropriate to bill the 93303 CPT code when a complete transthoracic echocardiography is performed to evaluate congenital cardiac anomalies. This code should be used for patients with suspected or confirmed congenital heart defects, requiring a comprehensive assessment of the heart structures and function.

6. Documentation requirements

To support a claim for CPT 93303, the following information should be documented:

• Patient’s medical history, including any family history of congenital heart defects or relevant symptoms
• Indication for the procedure, such as suspected or confirmed congenital cardiac anomaly
• Details of the procedure, including the views obtained and any additional imaging techniques used
• Findings of the echocardiogram, including any identified congenital abnormalities and their severity
• Interpretation and clinical impression of the echocardiogram results

7. Billing guidelines

When billing for CPT code 93303, consider the following guidelines:

• Append modifier 26 (Professional component) if reporting only the professional component of the service.
• Append modifier TC (Technical component) if reporting only the technical component of the service, unless the hospital provided the technical component.
• Do not append a professional or technical modifier when reporting a global service in which one provider renders both components.
• If the provider suspects a congenital issue but does not find one, use a noncongenital echocardiography code, such as CPT 93306.
• If spectral or color-flow Doppler is performed, consider add-on codes 93320 and 93325.

8. Historical information

CPT 93303 was added to the Current Procedural Terminology system on January 1, 1997. There have been no updates to the code since its addition.

9. Similar codes to CPT 93303

Five similar codes to CPT 93303 and how they differ are:

• CPT 93304: Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study. This code is used for follow-up or limited studies, rather than a complete assessment.
• CPT 93306: Echocardiography, transthoracic, complete, without spectral or color Doppler echocardiography. This code is used for noncongenital echocardiography without Doppler.
• CPT 93307: Echocardiography, transthoracic, complete, without spectral Doppler echocardiography. This code is used for noncongenital echocardiography without spectral Doppler.
• CPT 93308: Echocardiography, transthoracic, follow-up or limited study. This code is used for follow-up or limited noncongenital echocardiography.
• CPT 93312: Transesophageal echocardiography for congenital cardiac anomalies. This code is used for transesophageal echocardiography, rather than transthoracic.

10. Examples

Here are 10 detailed examples of CPT code 93303 procedures:

1. A newborn with a suspected congenital heart defect due to a heart murmur detected during a physical examination.
2. A child with a family history of congenital heart disease presenting with shortness of breath and cyanosis during exertion.
3. An adult with a history of congenital heart disease requiring a comprehensive assessment of their cardiac function and anatomy.
4. A pregnant woman with a history of congenital heart disease requiring evaluation of her cardiac function before delivery.
5. A patient with an abnormal finding on a previous cardiac imaging study suggestive of a congenital heart defect.
6. A patient with Marfan syndrome requiring a comprehensive assessment of their cardiac structures due to the increased risk of congenital heart defects.
7. A patient with Down syndrome presenting with signs of heart failure, requiring a complete evaluation of their cardiac function and anatomy.
8. A patient with a history of a repaired congenital heart defect requiring a comprehensive assessment of their cardiac function and anatomy to monitor for complications.
9. A patient with a suspected congenital heart defect due to abnormal blood flow detected during a physical examination.
10. A patient with a history of a heart transplant due to a congenital heart defect requiring a comprehensive assessment of their cardiac function and anatomy to monitor for complications.