Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Echocardiogram billed as complete when limited views obtained
Very Common93350 (echocardiogram transthoracic complete) requires 2D imaging with M-mode and Doppler of: LV size/function, RV, LA, RA, aortic valve, mitral valve, tricuspid valve, pulmonic valve, pericardium, and Doppler assessment. Denied when limited study performed (focused views), when technical quality prevents complete evaluation, or when follow-up echo on known single issue.
Common Causes
- • Report documents LV function only - that's limited 93308, not complete 93350
- • Study for pre-op clearance focused on LV - limited exam even if multiple views obtained
- • Poor acoustic windows prevent full valve assessment but billed as complete
Resolution Strategy
Document complete exam: 'Complete transthoracic echocardiogram. 2D imaging: LV size normal, EF 55-60%, no wall motion abnormalities. RV normal size/function. LA mildly dilated. RA normal. M-mode measurements: LVIDd 4.8cm, LVIDs 3.2cm. Doppler: Aortic valve trileaflet, trace AI, peak velocity 1.2 m/s. Mitral valve normal, mild MR. Tricuspid valve normal, trace TR, RVSP 28 mmHg. Pulmonic valve normal. No pericardial effusion.' Must document: all four chambers, all four valves, pericardium, both 2D and Doppler. If any component missing, bill limited 93308. Appeal only if complete exam actually performed but inadequately documented. Success rate moderate if amended report shows all components.
Relative Value Units (RVUs)
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Clinical Information
When to Use
For stress echocardiography with exercise or pharmacologic stress
Common Scenarios
Documentation Requirements
- Indication for stress echocardiography
- Type of stress used (exercise vs pharmacologic)
- Rest and stress images
- Wall motion assessment
- Interpretation and report
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes rest and stress echocardiography
- Includes stress testing
- Includes interpretation
- Baseline echocardiography coded separately
- Transesophageal echocardiography coded separately
Exclusions
- 93303 (transthoracic echocardiography, rest only)
- 93306 (complete transthoracic echocardiography)
- 93307 (complete transthoracic echocardiography without Doppler)
- 93015 (cardiovascular stress test)
Coding Notes
Clinical scenarios
- Indication for stress echocardiography
- Type of stress used (exercise vs pharmacologic)
- Rest and stress images
- Indication for stress echocardiography
- Type of stress used (exercise vs pharmacologic)
- Rest and stress images
- Indication for stress echocardiography
- Type of stress used (exercise vs pharmacologic)
- Rest and stress images
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
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Ask a QuestionFrequently Asked Questions
CPT 93350 is the billing code for "Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report". For stress echocardiography with exercise or pharmacologic stress
Medicare pays approximately $176.94 for CPT 93350 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.
CPT 93350 has a total RVU of 12.12, broken down as: Work RVU 4.20, Practice Expense RVU 7.50, and Malpractice RVU 0.42. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 93350 is "Echocardiogram billed as complete when limited views obtained". 93350 (echocardiogram transthoracic complete) requires 2D imaging with M-mode and Doppler of: LV size/function, RV, LA, RA, aortic valve, mitral valve, tricuspid valve, pulmonic valve, pericardium, and Doppler assessment. Denied when limited study performed (focused views), when technical quality prevents complete evaluation, or when follow-up echo on known single issue. Common causes include: Report documents LV function only - that's limited 93308, not complete 93350; Study for pre-op clearance focused on LV - limited exam even if multiple views obtained. Appeal success rate is approximately 40-60%.
Key documentation requirements for CPT 93350 include: Indication for stress echocardiography; Type of stress used (exercise vs pharmacologic); Rest and stress images; Wall motion assessment. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 93350: Includes rest and stress echocardiography. Includes stress testing Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 93350 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 93350 is 60-90 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.