Want to know the important details of CPT code 93325? Let’s just clarify that it is an add-on code for color Doppler imaging! Echocardiography is quite popular in cardiology. It, however, has different techniques. Among the 7.1 million annual echocardiograms in the U.S., cardiologists often perform the Doppler technique to assess and measure a heart’s blood flow.
You can use the 93325 CPT code to bill for this service. But as coding professionals, we understand that healthcare providers often get confused about one thing. Does this code have the same billing rules as other add-on codes? Therefore, we have covered it in quite detail in this blog.
CPT Code 93325 – Description
Let us begin with a simple explanation of this code. CPT code 93325, as we mentioned in the introduction, is an add-on code. It specifies a particular type of echocardiography, the Doppler echocardiogram. So, what is this procedure, and why do cardiologists perform it?
It is an integral part of a transthoracic echocardiographic (TTE) assessment, providing a precise hemodynamic evaluation (blood circulation). As the name implies, Doppler echocardiography relies on the Doppler effect (shifts in sound wave frequency) to measure the blood’s velocity and direction via different colors.
In simple words, this non-invasive test provides a 2D visualization of the blood flow within the heart chambers, across the valves, and in the great vessels. In short, cardiologists use the 93325 CPT code to report that they have performed this procedure to diagnose and evaluate heart conditions.
Appropriate Use Cases for CPT Code 93325
Let’s discuss some appropriate examples to understand CPT code 93325 better:
Post-Mitral Valve Repair Surgical Evaluation
Post-operative complications are quite common, especially after mitral valve repair operations. While mitral valve regurgitation affects 10% of the U.S. population, it is more common in older adults. Therefore, let’s suppose an older woman arrives with severe hypotension (extremely low blood pressure) six weeks after valve repair surgery.
The healthcare provider immediately performs a targeted echocardiogram (L-TTE) to identify the cause. He also uses the Doppler technique to evaluate the heart’s blood circulation. He then uses CPT code 93325 along with 93308 to bill for this service.
Arterial Thrombosis Evaluation
Arterial thrombosis is a common cause of heart attacks, strokes, and peripheral vascular disease. Since it is more common among people with an underlying medical condition, let’s imagine a middle-aged man with coronary artery disease. He arrives at an ER with sharp chest pain.
The healthcare provider performs several tests to determine the root cause. However, due to unsatisfactory results, he performs a transesophageal echocardiogram along with Doppler mapping to examine the patient’s heart in more detail. He then uses CPT code 93325 with 93312 to report these services.
Assessing a Fetus’s Blood Flow
A fetal echocardiogram is mandatory for all pregnant women with coronary heart disease at 18 to 22 weeks of gestation. Healthcare providers often perform Doppler imaging with this test. Therefore, let’s assume a 21-week pregnant woman arrives at a hospital for her scheduled fetal echocardiography.
During this real-time assessment, the technician includes Doppler imaging to assess the blood flow of the fetus. The primary purpose? To look for congenital heart defects. He then adds CPT code 93325 to 78625 to bill for these services.
Modifiers to Append with CPT Code 93325
Although CPT code 93325 is an add-on code, you can use the following modifiers with it, depending on the situation:
Modifier TC
Did you provide the equipment and technical support? Facilities usually bill this code with the modifier TC to report that they were responsible for the technical part of the Doppler echocardiogram.
Modifier 26
If you only interpreted the results of this non-invasive test, then you can append modifier 26 with CPT code 93325 to highlight your role.
Modifier 59 or XS
Let’s say you performed multiple services or echocardiograms in a day. For distinct or separately identifiable Doppler imaging, you can apply modifier 59 or modifier XS to CPT code 93325.
Reimbursement Guidelines for CPT Code 93325
For proper billing and timely reimbursements, follow these instructions for CPT code 93325:
Report 93325 with a Primary Echocardiography Code
As you might have learned from the scenarios, 93325 is an add-on code. Hence, it is always reported with a primary echocardiography code, including 93308, 93313, 93314, 76825, and 76827. Therefore, avoid billing the Doppler echocardiogram as a separate service.
Thoroughly Document the Doppler Echocardiogram
You must also justify the use of CPT code 93325. Almost all payers will reject your claim without proper clinical justification. Therefore, justify the medical necessity of Doppler imaging with complete and separate documentation.
Apply Appropriate Modifiers
While CPT code 93325 does not typically require modifiers, you can use some of them, such as TC, 26, and 59, to communicate unusual circumstances. For example, if a woman is pregnant with twins, you can use modifier 59 or XS with 93325 to indicate you performed fetal Doppler echocardiograms for each fetus at separate encounters.
Avoid Basic Mistakes
Even a minor billing mistake can result in claim rejections. Therefore, avoid common mistakes, like incorrect bundling, insufficient or missing documentation, or inappropriate modifiers. Always double-check payer requirements when reporting CPT code 93325.
Final Thoughts on CPT Code 93325
Satisfied with the covered details? We have tried to answer all your questions in this comprehensive guide. CPT code 93325 is an important code in cardiology, describing an integral component of echocardiography. To summarize, it specifies the Doppler color flow imaging technique that cardiologists use to evaluate a patient’s blood circulation.
You can use the discussed use cases and reimbursement guidelines to apply this code correctly. But if coding is still a stressful task for your practice, you can choose our cardiology billing services.
