CPT code 93306 is used for a complete transthoracic echocardiogram with Doppler, a detailed heart ultrasound to assess structure and function.
CPT code 93306 is used to describe a complete transthoracic echocardiogram (TTE) with Doppler studies. This procedure involves a non-invasive ultrasound examination of the heart, which provides detailed images of the heart's structure and function. The "complete" aspect indicates that the study includes a comprehensive assessment of the heart chambers, valves, and surrounding structures. The Doppler component measures the speed and direction of blood flow through the heart and its vessels, helping to identify any abnormalities in blood flow patterns. This code is typically used by healthcare providers to document and bill for a thorough cardiac evaluation using echocardiography technology.
For CPT code 93306, which pertains to a complete transthoracic echocardiogram with Doppler, several modifiers may be applicable depending on the specific circumstances of the service provided. Here is a list of potential modifiers that could be used:
1. Modifier 26 - Professional Component: This modifier is used when only the professional component of the service is being billed. It indicates that the provider is billing for the interpretation of the echocardiogram results, not the technical component.
2. Modifier TC - Technical Component: This modifier is used when only the technical component of the service is being billed. It indicates that the provider is billing for the use of equipment and the performance of the echocardiogram, excluding the interpretation.
3. Modifier 59 - Distinct Procedural Service: This modifier may be used if the echocardiogram is performed as a distinct service from other procedures on the same day. It is used to indicate that the service is separate and should not be bundled with other procedures.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used if the echocardiogram is repeated on the same day by the same physician. It indicates that the repeat procedure was necessary.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used if the echocardiogram is repeated on the same day by a different physician. It indicates that the repeat procedure was necessary and performed by another provider.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although less common for echocardiograms, this modifier could be used if the test is repeated for clinical reasons, such as verifying results.
7. Modifier 52 - Reduced Services: This modifier is used if the echocardiogram was partially completed or if the full service was not necessary. It indicates that the service was reduced in scope.
8. Modifier 53 - Discontinued Procedure: This modifier is used if the echocardiogram was started but discontinued due to patient safety or other reasons.
Each modifier serves a specific purpose and should be used in accordance with the guidelines set forth by the American Medical Association (AMA) and payer policies to ensure accurate billing and reimbursement.
CPT code 93306 is reimbursed by Medicare, as it is included in the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered.
However, the reimbursement for CPT code 93306 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). MACs are responsible for processing Medicare claims and have the authority to make coverage decisions and set reimbursement rates within their jurisdictions.
Therefore, it is essential for healthcare providers to verify the specific reimbursement details for CPT code 93306 with their respective MAC to ensure accurate billing and optimal revenue cycle management.
Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 93306, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and optimize your revenue cycle management.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
