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93351

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

Cardiology Echocardiography 17.45 Total RVUs
Quick Reference
For stress echocardiography with exercise or pharmacologic stress

Audit Defense & Denial Intelligence

Research-based denial patterns from OrbDoc Bill Analyzer

High overall risk
Top issues: Stress echocardiography not justified over standard stress ECG or study incomplete

1. Stress echocardiography not justified over standard stress ECG or study incomplete

Very Common

93351 (stress echocardiography) more expensive than standard exercise ECG (93015). Denied when standard stress ECG would be adequate, when patient has baseline ECG abnormalities not documented, or when study non-diagnostic. Stress echo indicated when: baseline ECG uninterpretable (LBBB, paced rhythm, LVH with strain), equivocal stress ECG, or assessing viability post-MI.

Common Causes

  • Stress echo ordered without documenting why standard stress ECG inadequate - ECG interpretable
  • No baseline ECG abnormality documented (LBBB, paced, digoxin) - standard stress adequate
  • Patient unable to exercise, pharmacologic stress not documented - dobutamine protocol missing

Resolution Strategy

Document indication for stress echo over ECG: 'Patient with exertional dyspnea, concern for CAD. Baseline ECG shows left bundle branch block - standard exercise ECG uninterpretable for ischemia with LBBB. Stress echocardiography necessary to assess for wall motion abnormalities during stress. Patient achieved target heart rate, no wall motion abnormalities seen, normal LV systolic function.' Alternative: 'Prior stress ECG equivocal with 0.5mm ST depression, unable to determine significance. Stress echo ordered to evaluate for wall motion abnormalities and clarify ischemic vs non-ischemic changes.' Must specify: why standard stress ECG inadequate (LBBB, paced, prior equivocal), stress protocol (exercise vs dobutamine), echo quality adequate for interpretation. If ECG interpretable, stress echo not justified.

Appeal Success: High
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Relative Value Units (RVUs)

Calculator →
Work RVU
4.50
Physician effort
PE RVU
12.50
Practice expense
MP RVU
0.45
Malpractice
Total RVU
17.45
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

For stress echocardiography with exercise or pharmacologic stress

Time Requirement
60-90 minutes typical procedure time

Common Scenarios

Stress echocardiography for ischemia
Exercise stress echocardiography
Pharmacologic stress echocardiography
Stress echo for coronary artery disease
Stress echo for cardiac function assessment

Documentation Requirements

  • Indication for stress echocardiography
  • Stress method used
  • Rest and stress images
  • Wall motion analysis
  • Interpretation and report

Coding Guidelines

Common Modifiers

26 Professional component only (interpretation)
TC Technical component only (equipment/staff)
59 Distinct procedural service if performed separately

Bundling Rules

  • Includes rest and stress echocardiography
  • Includes stress test
  • Includes interpretation and report
  • Rest echocardiography coded separately
  • Stress test coded separately

Exclusions

  • 93350 (stress echocardiography, different code)
  • 93303 (rest echocardiography only)
  • 93015 (cardiovascular stress test)
  • 93306 (complete echocardiography)

Coding Notes

No global period - diagnostic procedure
Includes rest and stress imaging
Includes stress test
Professional and technical components may be separate

Clinical scenarios

Stress echocardiography for ischemia
Stress echocardiography for ischemia
When to use:For stress echocardiography with exercise or pharmacologic stress
  • Indication for stress echocardiography
  • Stress method used
  • Rest and stress images
Pitfalls:Stress echocardiography not justified over standard stress ECG or study incomplete
Exercise stress echocardiography
Exercise stress echocardiography
When to use:For stress echocardiography with exercise or pharmacologic stress
  • Indication for stress echocardiography
  • Stress method used
  • Rest and stress images
Pitfalls:Stress echocardiography not justified over standard stress ECG or study incomplete
Pharmacologic stress echocardiography
Pharmacologic stress echocardiography
When to use:For stress echocardiography with exercise or pharmacologic stress
  • Indication for stress echocardiography
  • Stress method used
  • Rest and stress images
Pitfalls:Stress echocardiography not justified over standard stress ECG or study incomplete

Who are you?

Code Details

Code 93351
Category Cardiology
Subcategory Echocardiography
Total RVUs 17.45

Medicare Pricing

PFS
2025 National Rate
$222.54
Facility
$222.54
Non-Facility
$222.54
RVU Breakdown
Work RVU:1.75PE RVU:5.04MP RVU:0.09Total RVU:6.88CF:$32.3465Global Days:XXX
OPPS Details
APC:5524Status:SCopayment:
Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 93351?

CPT 93351 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

How much does Medicare pay for CPT 93351?

Medicare pays approximately $222.54 for CPT 93351 (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.

What are the RVUs for CPT 93351?

CPT 93351 has a total RVU of 17.45, broken down as: Work RVU 4.50, Practice Expense RVU 12.50, and Malpractice RVU 0.45. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Why was my 93351 claim denied?

The most common denial reason for CPT 93351 is "Stress echocardiography not justified over standard stress ECG or study incomplete". 93351 (stress echocardiography) more expensive than standard exercise ECG (93015). Denied when standard stress ECG would be adequate, when patient has baseline ECG abnormalities not documented, or when study non-diagnostic. Stress echo indicated when: baseline ECG uninterpretable (LBBB, paced rhythm, LVH with strain), equivocal stress ECG, or assessing viability post-MI. Common causes include: Stress echo ordered without documenting why standard stress ECG inadequate - ECG interpretable; No baseline ECG abnormality documented (LBBB, paced, digoxin) - standard stress adequate. Appeal success rate is approximately 70-80%.

What documentation is required for CPT 93351?

Key documentation requirements for CPT 93351 include: Indication for stress echocardiography; Stress method used; Rest and stress images; Wall motion analysis. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 93351 be billed with other codes?

Bundling considerations for CPT 93351: Includes rest and stress echocardiography. Includes stress test Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 93351?

Common modifiers for CPT 93351 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.

What is the time requirement for CPT 93351?

The typical time requirement for CPT 93351 is 60-90 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.

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