Cardiology Coding Alert

Stress Echo Update: 93351-26 Is Correct for Stress Test With Echo in Facility, CPT® Says

- Published on Wed, Dec 14, 2011

Accurate coding depends on which elements your physician performed.

Review the 2012 Echocardiography guidelines that precede 93303-+93352, and you'll find new wording that clarifies coding for a stress test with a stress echo.

Complete: When a single physician performs a stress echo and a complete cardiovascular stress test, report 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; including performance of continuous electrocardiographic monitoring, with physician supervision).

Professional component only: If your cardiologist provides only the professional component of the stress test and stress echo (such as in a facility), CPT® guidelines instruct you to append modifier 26 (Professional component) to 93351.

This language brings the CPT® approach more in line with Medicare policy, which states that "93351 (26) is payable when performed by a physician in a facility setting" (

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