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Official Description

Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93352 refers to the use of an echocardiographic contrast agent during a stress echocardiography procedure. This code is specifically designated as an add-on code, meaning it is reported in conjunction with a primary procedure code for stress echocardiography. The use of a contrast agent enhances the visualization of cardiac structures and dynamics, allowing for a more detailed assessment of the heart's function during stress testing. The contrast agent is administered intravenously and is titrated to achieve optimal left ventricular opacification, which is crucial for accurate imaging. This procedure typically involves a baseline echocardiogram at rest, followed by a stress component where the patient's heart is subjected to increased workload, either through exercise or pharmacological means. The echocardiographic images are captured in real-time, providing valuable insights into the heart's performance under stress conditions. The integration of contrast agents in this context is essential for identifying abnormalities in cardiac structure and function that may not be as easily discernible without their use.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The use of CPT® Code 93352 is indicated in the following scenarios:

  • Stress Echocardiography: This procedure is performed to evaluate cardiac function and structure during physical or pharmacological stress, particularly in patients with suspected coronary artery disease or other cardiac conditions.
  • Assessment of Cardiac Abnormalities: It is indicated when there is a need to assess abnormalities in cardiac structure or dynamics that may not be clearly visualized on standard echocardiography.
  • Evaluation of Ventricular Function: The procedure is used to evaluate left ventricular wall motion and function, especially in patients with known or suspected heart disease.

2. Procedure

The procedure involving CPT® Code 93352 consists of several detailed steps:

  • Preparation: The patient is prepared for the stress echocardiography by connecting a three-lead ECG for gating purposes. A baseline echocardiogram is obtained while the patient is at rest to evaluate cardiac structure and dynamics.
  • Baseline Echocardiogram: During this phase, a series of real-time tomographic images are recorded digitally or on videotape. The physician assesses various parameters, including ventricular function, chamber sizes, wall thickness and motion, aortic roots, and cardiac valves. Multiple transducer positions may be utilized to capture images from different cardiac windows.
  • Stress Component Initiation: The exercise portion of the study is initiated, with continuous monitoring of heart rate and blood pressure. A staged stress protocol is employed, and the patient's response to the stress is closely observed.
  • Administration of Contrast Agent: If indicated, an echocardiographic contrast agent is administered intravenously during the stress component. The dose is titrated to achieve the necessary left ventricular opacification, enhancing the quality of the images obtained.
  • Image Acquisition: Pre-stress images are captured, followed by additional images at peak stress or immediately post-stress after administering a second dose of contrast. This allows for a comprehensive evaluation of the heart's performance under stress.
  • Post-Procedure Monitoring: The patient is monitored until their heart rate returns to normal, and the intravenous catheter is subsequently removed.
  • Review and Interpretation: The physician or qualified health care professional reviews and interprets the contrast-enhanced images, providing a detailed written report of findings, including any abnormalities noted during the procedure.

3. Post-Procedure

After the completion of the stress echocardiography with the use of an echocardiographic contrast agent, the patient is monitored to ensure that their heart rate returns to baseline levels. The intravenous catheter used for the administration of the contrast agent is removed once monitoring is complete. The physician or other qualified health care professional will review the contrast-enhanced images obtained during the procedure and provide a comprehensive written report detailing the findings. This report may include comparisons to any previous cardiac studies to identify changes in cardiac function or structure. It is essential for the physician to document any abnormalities observed and to communicate these findings effectively for further clinical decision-making.

Short Descr ADMIN ECG CONTRAST AGENT
Medium Descr USE OF ECHO CONTRAST AGENT DURING STRESS ECHO
Long Descr Use of echocardiographic contrast agent during stress echocardiography (List separately in addition to code for primary procedure)
Status Code Active Code
Global Days ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC) 0 - Physician Service Code
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 Not Billable to the MAC
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.

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
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.
CR Catastrophe/disaster related
GZ Item or service expected to be denied as not reasonable and necessary
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.
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).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
GA Waiver of liability statement issued as required by payer policy, individual case
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
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
ME The order for this service adheres to 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
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q3 Live kidney donor surgery and related services
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)
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2009-01-01 Added -
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