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Doppler echocardiography, specifically coded as CPT® 93321, is a specialized ultrasound technique utilized to assess and measure blood flow dynamics within the heart's chambers, valves, and associated arteries. This procedure employs spectral Doppler technology, which can utilize either pulsed wave or continuous wave methods to provide detailed information about the direction and velocity of blood flow. During the examination, a conductive gel is applied to the patient's chest to facilitate the transmission of sound waves. A handheld transducer is then maneuvered over the chest area, emitting and receiving these sound waves to create a visual representation of blood flow patterns. The spectral Doppler technique is particularly effective in evaluating antegrade flow, which refers to the forward movement of blood through the heart's inflow and outflow tracts, as well as across the cardiac valves. The procedure may require multiple positions or orientations of the transducer to capture comprehensive data. Initially, the physician reviews the echocardiographic images obtained during the study and may order additional images if necessary to further investigate any identified abnormalities. The resulting digital or videotaped images are meticulously analyzed by the physician, who notes any irregularities in cardiac structure or function. The extent of these abnormalities is quantified, and comparisons are made with previous cardiac studies to identify any significant changes, whether quantitative or qualitative. Ultimately, the physician provides a thorough interpretation of the spectral Doppler echocardiography findings, accompanied by a written report that details the results. It is important to note that CPT® 93321 is specifically designated for follow-up or limited studies, and should be billed separately in addition to codes for echocardiographic imaging, such as CPT® 93320, which is used for initial complete studies.
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The indications for performing Doppler echocardiography, coded as CPT® 93321, include the evaluation of various cardiovascular conditions and symptoms that may necessitate further investigation of blood flow dynamics within the heart. These indications may encompass:
The procedure for Doppler echocardiography, CPT® 93321, involves several key steps to ensure accurate assessment of blood flow within the heart. These steps include:
Post-procedure care following Doppler echocardiography, CPT® 93321, typically involves minimal recovery time, as the procedure is non-invasive and does not require sedation. Patients may resume normal activities immediately after the examination. The physician will review the findings and discuss any necessary follow-up actions or additional testing that may be warranted based on the results. It is essential for patients to understand the importance of follow-up appointments to monitor any identified cardiac conditions and to ensure ongoing evaluation of their heart health.
| Short Descr | DOPPLER ECHO F-UP/LMTD STD | Medium Descr | DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD | Long Descr | Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); follow-up or limited study (List separately in addition to codes for echocardiographic imaging) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | I3C - Echography/ultrasonography - heart | MUE | 1 | CCS Clinical Classification | 193 - Diagnostic ultrasound of heart (echocardiogram) |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 93303 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Transthoracic echocardiography for congenital cardiac anomalies; complete | 93304 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study | 93308 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, follow-up or limited study | 93312 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report | 93314 | MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); image acquisition, interpretation and report only | 93315 | MPFS Status: Carrier Priced APC S PUB 100 CPT Assistant Article Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report | 93317 | MPFS Status: Carrier Priced APC N PUB 100 CPT Assistant Article Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only | 93350 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article 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 | MPFS Status: Active Code APC S CPT Assistant Article 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 | C8921 | Medicare Coverage: Special Coverage Instructions APC S Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | C8922 | Medicare Coverage: Special Coverage Instructions APC S Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study | C8924 | Medicare Coverage: Special Coverage Instructions APC S Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study | C8925 | Medicare Coverage: Special Coverage Instructions APC S Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report | C8926 | Medicare Coverage: Special Coverage Instructions APC S Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report | C8928 | Medicare Coverage: Special Coverage Instructions APC S Transthoracic echocardiography with contrast, or without contrast followed by with contrast, 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 | C8930 | Medicare Coverage: Special Coverage Instructions APC S Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, 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 |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GZ | Item or service expected to be denied as not reasonable and necessary | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | CR | Catastrophe/disaster related | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GW | Service not related to the hospice patient's terminal condition | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AM | Physician, team member service | CG | Policy criteria applied | ET | Emergency services | FS | Split (or shared) evaluation and management visit | GA | Waiver of liability statement issued as required by payer policy, individual case | GX | Notice of liability issued, voluntary under payer policy | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | MC | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues | MF | The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q3 | Live kidney donor surgery and related services | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional | QW | Clia waived test | UD | Medicaid level of care 13, as defined by each state | X3 | Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2011-01-01 | Changed | Short description changed. |
| 1990-01-01 | Added | First appearance in code book in 1990. |
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