How To Use CPT Code 93351

CPT 93351 is a code used for transthoracic echocardiography during rest and cardiovascular stress tests, including interpretation and report. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93351 procedures.

1. What is CPT 93351?

CPT 93351 is a medical billing code used to describe a specific type of echocardiography procedure that is performed during rest and cardiovascular stress tests. This code includes the interpretation and report of the procedure, as well as continuous electrocardiographic monitoring and supervision by a physician or other qualified health care professional.

2. 93351 CPT code description

The official description of CPT code 93351 is: 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.

3. Procedure

1. The patient is prepared for the echocardiography procedure, which may include applying a gel to the chest wall and positioning a small probe on the chest.
2. The probe generates ultrasound in the form of M-mode, capturing one-dimensional motion and position of the heart and its chambers on a paper strip. This is known as two-dimensional motion.
3. The provider records a sequence of sections of images while the patient is at rest.
4. The patient then exercises on a treadmill or stationary bicycle, or undergoes pharmacologically induced stress.
5. The provider records another sequence of sections of images during the stress test.
6. Continuous electrocardiographic monitoring is performed throughout the procedure, supervised by a physician or other qualified health care professional.
7. The provider interprets the echocardiographic images and creates a report detailing the findings.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 93351 services are those who require an evaluation of their heart function during rest and stress conditions. This may include individuals with suspected or known coronary artery disease, valvular heart disease, or other cardiac conditions that may cause chest pain or other symptoms. The procedure may also be used to monitor the effectiveness of treatments or to assess the risk of future cardiac events.

5. When to use CPT code 93351

It is appropriate to bill the 93351 CPT code when a transthoracic echocardiography procedure is performed during rest and cardiovascular stress tests, with interpretation and report, and continuous electrocardiographic monitoring supervised by a qualified health care professional. This code should be used when the procedure is medically necessary and meets the qualifying circumstances outlined above.

6. Documentation requirements

To support a claim for CPT 93351, the following information should be documented:

• Patient’s medical history and reason for the procedure
• Details of the echocardiography procedure, including the type of stress test performed (treadmill, bicycle, or pharmacological)
• Findings from the echocardiographic images, both at rest and during stress
• Interpretation and report of the echocardiographic findings
• Continuous electrocardiographic monitoring results
• Supervision by a physician or other qualified health care professional

7. Billing guidelines

When billing for CPT code 93351, it is important to follow the appropriate guidelines and rules. This code contains both a technical and professional component. Append modifier TC when reporting the technical component, and modifier 26 when reporting the professional component. Do not report CPT 93351 in conjunction with codes 93015-93018 or 93350. Additionally, do not report CPT 93351-26 in conjunction with codes 93016, 93018, or 93350-26.

8. Historical information

CPT 93351 was added to the Current Procedural Terminology system on January 1, 2009. The code was changed on January 1, 2013, with the previous descriptor being “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 physician supervision.”

9. Similar codes to CPT 93351

Five similar codes to CPT 93351 and how they differentiate are:

1. CPT 93350: This code is used for echocardiography during rest and stress tests but does not include continuous electrocardiographic monitoring or supervision by a qualified health care professional.
2. CPT 93016: This code is used for physician supervision only during a cardiovascular stress test, without interpretation and report.
3. CPT 93018: This code is used for the interpretation and report of a cardiovascular stress test only, without physician supervision.
4. CPT 93306: This code is used for a complete transthoracic echocardiography procedure, including 2D, M-mode, and Doppler, but does not include stress testing.
5. CPT 93308: This code is used for a limited or follow-up transthoracic echocardiography procedure, without stress testing.

10. Examples

Here are 10 detailed examples of CPT code 93351 procedures:

1. A patient with a history of chest pain undergoes a transthoracic echocardiography during rest and a treadmill stress test, with continuous electrocardiographic monitoring and physician supervision.
2. A patient with known coronary artery disease has a transthoracic echocardiography during rest and a bicycle stress test, with interpretation and report, and continuous electrocardiographic monitoring supervised by a qualified health care professional.
3. A patient with suspected valvular heart disease undergoes a transthoracic echocardiography during rest and a pharmacologically induced stress test, with continuous electrocardiographic monitoring and physician supervision.
4. A patient with a history of heart failure has a transthoracic echocardiography during rest and a treadmill stress test, with interpretation and report, and continuous electrocardiographic monitoring supervised by a qualified health care professional.
5. A patient with a recent myocardial infarction undergoes a transthoracic echocardiography during rest and a bicycle stress test, with continuous electrocardiographic monitoring and physician supervision.
6. A patient with a history of angina has a transthoracic echocardiography during rest and a pharmacologically induced stress test, with interpretation and report, and continuous electrocardiographic monitoring supervised by a qualified health care professional.
7. A patient with a family history of cardiomyopathy undergoes a transthoracic echocardiography during rest and a treadmill stress test, with continuous electrocardiographic monitoring and physician supervision.
8. A patient with a history of syncope has a transthoracic echocardiography during rest and a bicycle stress test, with interpretation and report, and continuous electrocardiographic monitoring supervised by a qualified health care professional.
9. A patient with a history of arrhythmias undergoes a transthoracic echocardiography during rest and a pharmacologically induced stress test, with continuous electrocardiographic monitoring and physician supervision.
10. A patient with a history of hypertension has a transthoracic echocardiography during rest and a treadmill stress test, with interpretation and report, and continuous electrocardiographic monitoring supervised by a qualified health care professional.