Diagnostic codes for echocardiogram with contrast

Q.

What diagnosis code(s) should we use for an echocardiogram performed with contrast?

A.

There really isn’t a special code. Where there are LCDs, the diagnosis codes (over 1000 in some cases) include regular 933xx codes as well as the C89xx codes for contrast ultrasound in the same groupings. Remember, Level ll C-codes are only to be used for coding and billing Medicare for Outpatient Prospective Payment System (OPPS) billing of hospital services. Do not submit these C-codes for other payers unless clearly instructed by the payer to use them instead of CPT codes. Since there is usually a requirement that at least two continuous segments of the left ventricular border cannot be seen before a contrast echo is covered, you may want to add diagnosis code R93.1 (abnormal findings on diagnostic tests of heart and coronary arteries) as a secondary diagnosis to indicate that.