Cardiology is a medical specialty that relies heavily on different diagnostic tests, imaging studies, and interventional procedures to assess and treat conditions related to the heart and circulatory system. Many CPT codes apply specifically to the types of services performed by cardiologists and cardiology practices. Properly using these cardiology CPT codes is crucial for appropriate reimbursement and to convey the complexity of care provided.
This blog post will overview the most frequently used CPT codes in cardiology. We’ll describe the codes with their application and any special billing tips or recent changes. Whether you are a cardiologist, work in a cardiology practice, or are responsible for cardiology medical billing and coding, understanding these key cardiology CPT codes is essential for your reimbursement and compliance.
Most Common Cardiology CPT Codes
Some of the most common cardiology CPT codes relate to electrocardiograms (EKGs), echocardiograms, cardiac catheterization, and stress testing. However, new codes are introduced over time with advancements in the field. Cardiology providers and medical coders must stay up-to-date on CPT codes and billing guidelines.
Electrocardiograms (EKGs) CPT Codes
93000 is one of the most commonly used codes in cardiology. It is used for routine EKG tracing and interpretation. This basic EKG code is used for routine annual exams, pre-operative clearance, and evaluating cardiac symptoms like chest pain, heart palpitations, dizziness, or syncope.
93005 is used for electrocardiogram tracing only, without interpretation and report. It allows separate billing for the EKG trace, which a cardiologist sometimes interprets later. The tracing-only code can be used when one provider performs the EKG trace recording, and another interprets it separately.
93010 is used when an interpretation is done from an already performed tracing. The interpretation and report code is used when a provider reviews and analyzes a tracing that was already completed. This often occurs when a cardiologist is consulted on an EKG done elsewhere.
93040 (rhythm ECG, one to three leads, with report) is used for enhanced rhythm EKGs that monitor cardiac rhythms over an extended time.
Echocardiogram CPT Codes
CPT code 93306 (Echocardiography, transthoracic) is the most common echocardiogram code for imaging the heart’s structure and function using ultrasound waves passed over the chest wall. CPT code 93306 is used for evaluating heart function, looking for valve disorders, assessing chamber size, calculating ejection fraction, and detecting abnormalities in heart structure.
93307 (Echocardiography, complete, without spectral Doppler) is for a full transthoracic echocardiogram without the Doppler assessment. 93308 (Echocardiography, limited, without spectral Doppler) code is used for focused or limited imaging of certain heart structures. 93307 and 93308 are often used to quickly assess known issues like post-surgery or post-MI evaluation of heart function.
Cardiac Catheterization
93452 (Left heart catheterization including imaging) involves catheterization of the left side of the heart, often coupled with angiography.
93453 (Combined right and left heart catheterization) code includes catheterization of both sides of the heart in the same procedure.
93456 (Left heart catheterization for congenital disabilities) is used for patients with congenital heart defects.
93458 (Left heart catheterization for acquired defects) is used for patients with acquired defects like coronary artery disease.
Stress Testing
93015 (Cardiovascular stress test using exercise and EKG monitoring) is the most common type of cardiac stress test. Exercise stress testing is commonly done to induce ischemia in patients with coronary artery disease and evaluate EKG changes.
93017 (Cardiovascular stress test with EKG monitoring and administration of the drug) is for pharmacologic stress testing. Pharmacologic stress testing is preferred for patients unable to exercise adequately on the treadmill.
Billing Tips and Modifiers
Modifiers are essential for delineating professional vs. technical components and bypassing bundling issues when performing multiple cardiac procedures—accurate use of modifiers results in better claim reimbursement.
Herein are some tips regarding the modifier’s usage in cardiology billing:
Electrocardiograms
- Modifier 59 can be added to cardiology CPT codes 93000 or 93010 when an EKG is performed in addition to an E/M service on the same day. This avoids bundled payment.
- Modifier 26 is used with 93005 when only the professional component of an EKG trace is being billed separately.
Echocardiograms
- Modifier 26 is added for professional component billing only.
- Modifier TC is only applied for technical component billing by the facility/equipment with an echocardiogram CPT code.
Cardiac Catheterization
- Modifier 59 may be needed if a diagnostic Cath is bundled with a surgical intervention.
- Modifiers LC, LD, RC, and LD define vessel(s) imaged during angiography.
- Modifier 22 is used to indicate increased complexity for congenital disabilities.
Stress Testing
- 93015 and 93017 need modifier 26 when only the professional component is billed.
- Modifier TC is used if only the facility billed the technical component.
- Modifier 59 may be required if a stress test is done with other cardiac procedures.
Recent Changes to Codes
Staying current with new and updated CPT codes is essential in cardiology to capture reimbursement for the latest procedures and technology improvements. Regular code updates from the AMA and CMS keep cardiology billing aligned with the rapid pace of advancement.
Code 93X34 was introduced for prolonged external ECG patch monitoring exceeding 48 hours. This new code reflects the extended EKG monitoring now possible with patch devices. January 2022 added codes for cardiac magnetic resonance imaging (MRI) with contrast – 75561, 75563, and 75564. This provides more specific coding for cardiac MRIs beyond the previous broad MRI codes. Code 93356 was created in 2022 for transesophageal echocardiography for congenital cardiac anomalies. This includes differentiation from the standard TEE code 93355. January 2022 introduced +93600 intracardiac echocardiography during therapeutic/diagnostic intervention. This reflects the increasing use of ICE during procedures like Ablation.
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Conclusion
Proper application of CPT codes is vital for cardiology medical billing and reimbursement. As cardiology is a fast-evolving medical specialty, new codes are introduced frequently to keep pace with technological advances. Some of the most common cardiology CPT codes relate to EKGs, echocardiography, cardiac catheterization, and stress testing. However, there are many specific codes for emerging techniques like cardiac MRI, CT angiography, intracardiac echocardiography, and newer interventional procedures. Accurate coding requires understanding what each code represents and when to apply the correct code.
Keeping up with cardiology CPT code changes, additions, billing tips, and modifier usage is essential but challenging. This is where the experienced medical billing and coding team at Precision Hub can help. Our team specializes in cardiology and is up-to-date on the latest coding protocols. We handle all aspects of cardiology medical billing. With Precision Hub as your cardiology medical billing partner, you can rest assured your practice is coding properly and optimizing revenue. Our team stays on top of updates related to cardiology CPT codes so you can focus on delivering excellent patient care. Contact us today to learn more about our medical billing and coding services.
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