How To Use CPT Code 93304

CPT 93304 describes the procedure for a limited or follow-up transthoracic echocardiography to evaluate congenital cardiac anomalies. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93304?

CPT 93304 can be used to describe a limited or follow-up transthoracic echocardiography performed to evaluate congenital cardiac anomalies. This procedure involves obtaining images of the heart through the chest wall using high-frequency sound waves. It is a focused examination that aims to re-evaluate known congenital abnormalities based on a previous complete echo.

2. Official Description

The official description of CPT code 93304 is: ‘Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study.’

3. Procedure

1. The provider prepares the patient and applies a gel on the chest wall.
2. A small transducer is placed on the chest wall, and high-frequency sound waves are emitted.
3. The sound waves bounce off the heart and are captured by the transducer, which sends the signals to a monitor.
4. The provider moves the transducer in different directions on the chest to obtain views of the heart.
5. The provider evaluates and re-assesses known congenital abnormalities based on a previous complete echo.

4. Qualifying circumstances

CPT 93304 is used for patients born with heart defects who require a limited or follow-up transthoracic echocardiography. It is specifically used to evaluate congenital cardiac anomalies, which are defects or abnormalities in the heart present since birth.

5. When to use CPT code 93304

CPT code 93304 should be used when a limited or follow-up transthoracic echocardiography is performed to evaluate congenital cardiac anomalies. It is not appropriate to use this code for non-congenital issues or when a complete echo is performed.

6. Documentation requirements

To support a claim for CPT 93304, the provider must document the following information:

• Reason for the limited or follow-up study
• Previous complete echo findings and congenital abnormalities
• Date and time of the procedure
• Images obtained and any abnormalities identified
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93304, the provider should append modifier 26 if reporting only the professional component. If reporting only the technical component, the provider should append modifier TC, unless the hospital provided the technical component. In that case, modifier TC should not be appended. It is important to note that CPT 93304 should not be reported if a congenital issue is suspected but not found; in such cases, a noncongenital echocardiography code should be used.

8. Historical information

CPT 93304 was added to the Current Procedural Terminology system on January 1, 1997. There have been no updates to the code since its addition.

9. Examples

1. A patient born with a congenital heart defect undergoes a limited transthoracic echocardiography to re-evaluate the known abnormalities.
2. A follow-up transthoracic echocardiography is performed on a patient with a previously diagnosed congenital cardiac anomaly.
3. A provider uses CPT 93304 to assess the progress of a patient’s congenital heart defect after a previous complete echo.
4. A limited study transthoracic echocardiography is performed on a patient with a known congenital cardiac anomaly to monitor any changes or developments.
5. A follow-up transthoracic echocardiography is conducted on a patient with a history of congenital heart disease to evaluate the effectiveness of previous interventions.
6. A provider performs a limited transthoracic echocardiography to assess the impact of a congenital cardiac anomaly on a patient’s overall heart function.
7. A patient with a known congenital heart defect undergoes a follow-up transthoracic echocardiography to monitor the progression of the anomaly.
8. A limited study transthoracic echocardiography is performed on a patient with a previously identified congenital cardiac anomaly to assess any changes in the condition.
9. A provider uses CPT 93304 to evaluate the effectiveness of a previous intervention for a patient with a congenital heart defect.
10. A follow-up transthoracic echocardiography is conducted on a patient with a known congenital cardiac anomaly to assess the need for further interventions or treatments.