As a reminder, effective for commercial HMO, POS, and PPO members for dates
of service on or after May 1, 2014, providers now need to obtain
precertification for outpatient echocardiography services, which include:
- stress echocardiography
- resting transthoracic echocardiography
- transesophageal echocardiography
The CPT® codes to which the precertification applies are listed
in the table below.
Echocardiography service
CPT® code
Description
93350
Transthoracic stress echo, complete
Stress echocardiography (SE)
93351
Transthoracic stress echo, complete w/cont EKG
93303
Transthoracic echo cardiac anomalies
93304
Transthoracic echo cardiac anomalies, limited
93306
Transthoracic echo complete w/color & spectral
93307
Transthoracic echo complete w/o color & spectral
Resting transthoracic echocardiography (TTE)
93308
Transthoracic echo limited
93312
Transesophageal echo
93313
Transesophageal echo probe only
93314
Transesophageal echo interpretation
93315
Transesophageal echo congenital
93316
Transesophageal echo congenital, probe only
Transesophageal echocardiography (TEE)
93317
Transesophageal echo congenital interpretation
93320*
Doppler echo complete
93321*
Doppler echo limited
93325*
Doppler echo flow velocity
Add-on codes
93352*
Echo contrast agent (SE only)
*Denotes a CPT code that is an add-on/secondary code to the primary code and
does not require precertification.
Precertification for outpatient echocardiography services can be obtained
through the NaviNet® web portal using the AIM Specialty
Health® (AIM) ProviderPortalSM. To do so, select
AIM from the Authorizations option in the Plan Transactions menu.
It is very important that providers use NaviNet to verify member-specific
requirements or refer to the precertification list on our website.
Failure to obtain precertification for any of the services or drugs that
require it may result in a reduction in payment or nonpayment for the services
not authorized.
Please call 1-800-ASK-BLUE if you have any questions about
this change. For additional information, please refer to Medical Policy
#09.00.46l: High-Technology Radiology Services on the Medical Policy Portal.
Note: These changes will go into effect for Medicare Advantage HMO and
PPO members on January 1, 2015.
AIM is an independent company contracted with IBC to perform precertification
for select diagnostic imaging services for most
managed care members.
NaviNet® is a registered trademark of NaviNet, Inc., an
independent company.
CPT copyright 2012 American Medical Association. All
rights reserved. CPT is a registered trademark of the American Medical
Association.