Need Your Help to Establish Reimbursement for Category III Echocardiographic CPT™ Codes

Coding accurately for the services you provide is essential, especially in today’s environment when you are facing declining reimbursement and increased scrutiny. ASE is committed to ensuring you are fairly reimbursed for your work. In this effort, the Society was able to establish two new Category III echocardiographic CPT™ codes and encourages you to use them when appropriate.

While category III codes are not reimbursed by the Centers for Medicare and Medicaid Services (CMS), these codes are sometimes reimbursed by private payers. ASE is meeting with private payers in an effort to establish reimbursement. Additionally, CMS will track submission of these codes. There will be an opportunity for this code to progress to Category I status over the next few years based on 1) utilization and 2) additional peer reviewed publications demonstrating efficacy.

CPT™ code +0399TMyocardial strain imaging has emerged as a sensitive tool for assessing regional and global left ventricular systolic function. +0399T is to be reported once per encounter in addition to the appropriate echocardiography base codes 93303-93351.

CPT™ code +0439T: Myocardial contrast perfusion echocardiography imaging code aids in the detection of myocardial ischemia and myocardial viability and is well-tolerated and safe in both ambulatory and critically ill patients. This code should be submitted whenever myocardial contrast perfusion echocardiography is performed but may be used only in conjunction with echocardiography base codes 93306, 93307, 93308, 93350, 93351.

There is a time frame for utilization. If the codes are not used they may “sunset” after five years, eliminating the opportunity to establish reimbursement and limiting patients’ access to the technology. Therefore, ASE is encouraging you to share information about these new codes with your lab staff and business departments and submit these codes whenever myocardial strain imaging or myocardial perfusion echocardiography is performed.