Ultrasound Reimbursement & CPT Codes

 
 
         
             
      Ultrasound Reimbursement & CPT Codes
   

             
             
      2012 Medicare Physicians Fee Schedule Unadjusted
                Unadjusted National Amount  
      Professional  Technical Global 2012 Medicare Outpatient
  CPT Code Description Fee-26 (1) Fee-TC (2) Fee (3) Prospective Payment
            System (OPPS) (4)
  93303 Transthoracic echocardiography for  $             64.33  $          143.64  $         207.97 $579.34
    congenital cardiac anomolies; complete       APC Code: 0270
            Status Indicator: S
  93304 Transthoracic echocardiography for  $             36.76  $            98.03  $         134.79 $392.78
    congenital cardiac anomolies; Follow-up       APC Code: 0269
    or limited study       Status Indicator: S
  93306 Echocardiogaphy, transthoracic, real-  $             64.67  $          148.40  $         213.08 $392.78
    time with image documentation (2D),       APC Code: 0269
    includes M-Mode recording, when       Status Indicator: S
    performed, complete, with spectral        
    Doppler Echocardiography, and with color        
    flow Doppler echocardiography        
  93307 Echocardiogaphy, transthoracic, real-  $             45.95  $            86.46  $         132.41 $392.78
    time with image documentation (2D),       APC Code: 0269
    includes M-Mode recording, when       Status Indicator: S
    performed, complete, without spectral        
    or color Doppler echocardiography        
  93308 Echocardiogaphy, transthoracic, real-  $             25.87  $            75.90  $         101.77 $221.17
    time with image documentation (2D),       APC Code: 0697
    includes M-Mode recording, when       Status Indicator: S
    performed, follow-up or limited study        
  93312 Echocardiography, tranesophogeal,  $           106.20  $          209.33  $         315.53 $579.34
    real-time with image documentation (2D)       APC Code: 0270
    (with or without M-mode recording);       Status Indicator: S
    including probe placement, image        
    acquisition, interpretation and report        
  93313 Echocardiography, tranesophogeal, N/A N/A 41.87 $392.78
    real-time with image documentation (2D)       APC Code: 0269
    (with or without M-mode recording);       Status Indicator: S
    placement of transesophogeal probe only        
  93314 Echocardiography, tranesophogeal,  $             60.59  $          226.01  $         286.60 Status Inicator: N
    real-time with image documentation (2D)        
    (with or without M-mode recording);        
    image acquisition, interpretation and         
    report only        
  93315 Transesophogeal echocardiograhy for  $           140.92  N/A   N/A  $392.78
    congental cardiac anomolies; including       APC Code: 0269
    probe placement, image acquisition,        Status Indicator: S
    interpretation and report        
  93317 Transesophogeal echocardiograhy for  $             92.58  N/A   N/A   Status Indicator: N 
    congental cardiac anomolies; image        
    acquisition, interpretation and report only        
  93318 Echocardiography, tranesophogeal  $           111.98  N/A   N/A  $579.34
    (TEE) for monitoring purposes, including       APC Code: 270
    probe placement, real time 2-dimensional       Status Indicator: S
    image acquisition and interpretaion        
    leading to ongoing (continuous)        
    assessment of (dynamically changing)        
    cardiac pumping function, and to         
    therapeutic measures on an immediate        
    time basis        
  93320 Doppler echocardiography, pulsed wave  $             18.72  $            35.40  $           54.12  Status Indicator: N 
    and/or continuous wave with spectral        
    display (List separately in addition to        
    codes for echocardiographic imaging);        
    compete        
  93321 Doppler echocardiography, pulsed wave  $               7.49  $            19.40  $           26.89  Status Indicator: N 
    and/or continuous wave with spectral        
    display (List separately in addition to        
    codes for echocardiographic imaging);        
    follow-up or limites study (List separately        
    in addition to codes for echocardiographic        
    imaging)        
  93325 Doppler echocardiography color flow  $               3.74  $            24.51  $           28.25  Status Indicator: N 
    velocity mapping (List separately in         
    addition to codes for echocardiography)        
  93350 Echocardiogaphy, transthoracic, real-  $             72.84  $          134.79  $         207.63 $392.78
    time with image documentation (2D),       APC Code: 0269
    includes M-Mode recording, when       Status Indicator: S
    performed, during rest and cardiovascular        
    stress test using treadmill, bicycle        
    exercise and/or pharmacologically        
    induced stress, with interpretation and         
    report           
  93351 Echocardiogaphy, transthoracic, real-  $             87.48  $          155.21  $         242.69 $579.34
    time with image documentation (2D),       APC Code: 0270
    includes M-Mode recording, when       Status Indicator: S
    performed, during rest and cardiovascular        
    stress test using treadmill, bicycle        
    exercise and/or pharmacologically        
    induced stress, with interpretation and         
    report; including performance of           
    continuous electrocardiographic        
    monitoring, with physician supervision        
  93352 Use of echocardiographic contrast agent  N/A   N/A   $           35.06 Status Indicator: M
    during stress echocardiography (List        
    seaparately in addition to code for primary        
    Procedure        
             
  Important Notes:        
             
  Status Indicators:        
  A-Not paid under OPPS. Paid by fiscal intermediaries/MACs under a fee schedule or payment system other than OPPS.
  B-Not paid under OPPS.        
  -May be paid by fiscal intermediaries/MACs when submitted on a different bill type, for example, 75x (CORF) but
  not paid under OPPS.        
  -An alternate code that is recognized by OPPS when submitted on an outpatient hospital Part B bill type (12x and 12x) may
  be available.        
  E-Not paid by medicare when submitted on outpatient claims (any outpatient bill type).  
  N-Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC
             
  Davis Medical Electronics, Inc. provides general reimbursement information related to the diagnosis of peripheral arterial disease as an overview for our customers.  It is important to understand that reimbursement is a complex process and requirements are subject to change without notice.  It is the responsibility of the healthcare provider to determine and submit appropriate codes, charges and modifiers for services that are rendered.  Prior to filing any claims, customers are advised to contact their third-party payers for specific coverage, coding and payment information. Davis Medical Electronics, Inc. makes no promise or guarantee of reimbursement by Medicare or any other third-party payer. 
 
 
  Davis Medical Electronics 2441 Cades Way Bldg 200 Vista, CA 92081   888-599-6641  www.davismedical.com
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