Legislative & Regulatory - American Society of Echocardiography

Coding Information for Contrast Echocardiography

CMS Initiates New HCPCS Codes for Reporting Echocardiograms with Contrast
For Hospital Outpatient Procedures
Effective January 1, 2008

Specific to hospital outpatient procedures only, CMS created eight new HCPCS codes (C8921 through C8928) to report echocardiography procedures when provided with contrast. The codes are assigned to new APC 0128 (Echocardiogram with Contrast). These new echocardiography codes package the contrast agent into the national payment rate, resulting in an additional payment for contrast and its administration. The new codes parallel current echocardiography CPT codes performed without contrast.
Hospitals performing outpatient echocardiography procedures without contrast should continue to use the current CPT codes. Echocardiography procedures performed with contrast should be reported with the newly developed C-codes. Note these C codes do not apply for reporting physician services.
Hospitals should check with commercial and private payers (non Medicare) to determine if these codes are applicable for reporting hospital outpatient echocardiography procedures with contrast.

Echocardiography HCPCS Codes for Procedures with and without Contrast

Echocardiography Without Contrast				Echocardiography With Contrast
HCPCS	Descriptor	APC	National payment	HCPCS	Descriptor	APC	National payment
93303	Transthoracic echocardiography for congenital cardiac anomalies; complete	0269	$406	C8921	Transthoracic echocardiography with contrast for congenital cardiac anomalies; complete	0128	$541
93304	Transthoracic echocardiography for congenital cardiac anomalies follow-up or limited study	0697	$213	C8922	Transthoracic echocardiography with contrast for congenital cardiac anomalies; follow-up or limited study	0128	$541
93307	Echocardiography, transthoracic, real-time with image documentation (2D) with or without M-mode recording; complete	0269	$406	C8923	Transthoracic echocardiography with contrast, real-time with image documentation (2D) with or without M-mode recording; complete	0128	$541
93308	Echocardiography, transthoracic, real-time with image documentation (2D) with or without M-mode recording; follow-up or limited study	0697	$213	C8924	Transthoracic echocardiography with contrast, real-time with image documentation (2D) with or without M-mode recording; follow-up or limited study.	0128	$541
93312	Echocardiography, transesophageal, real time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report	0270	$523	C8925	Transesophageal echocardiography (TEE) with contrast, real time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report	0128	$541
93315	Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report	0270	$523	C8926	Transesophageal echocardiography (TEE) with contrast for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report	0128	$541
93318	Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2 dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis.	0270	$523	C8927	Transesophageal echocardiography (TEE) with contrast for monitoring purposes, including probe placement, real time 2dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis	0128	$541
93350	Echocardiography, transthoracic, real-time with image documentation (2D), with or without M-mode recording, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report	0697	$406	C8928	Transthoracic echocardiography with contrast, real-time with image documentation (2D), with or without M-mode recording, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report	0128	$541

CMS Continues to Reimburse Contrast Agents Separately
When Provided in the Physician Office
Effective January 1, 2008

Physician offices that provide echocardiography exams with contrast can report the echo procedure with the contrast agent. Payments for contrast agents are based on the Average Sales Price plus 6%. Some Medicare carriers may require the submission of the invoice.

CMS Payment Allowance for Contrast Agents
January 1-March 31, 2008

HCPCS Code	Short Description	HCPCS Code Dosage	Payment Limit
Q9955	Inj, perflexane lipid microspheres, ml	1 ML	N/A
Q9956	Inj octafluoropropane mic,ml	1 ML	$49.608
Q9957	Inj perflutren lip micros,ml	1 ML	$62.591

These payments are updated quarterly by CMS.

ASE Members can access our advocacy pages and ask questions of our Coding Expert.