TTE affords unique insight into cardiac structure and function. It is a non-invasive technique in which pulsed high-frequency sound waves are used to visualize the contours, movements and dimensions of cardiac structures. Ultra-high frequency sound waves are directed toward and reflected by cardiovascular structures. Reflected echoes are translated into electrical impulses for display on a monitor and for recording and storage on either videotape or digital recording.
The most commonly utilized echocardiographic techniques are motion-mode (M-mode) and two-dimensional (2-D) echocardiography.
M-mode echocardiography employs a single pencil-like beam ultrasound view of cardiac structures. This method is especially useful for precisely recording the motion and dimensions of intracardiac structures with respect to time.
Two-dimensional echocardiography employs an ultrasound beam rapidly swept through an arc, producing a cross-sectional or fan-shaped view of cardiac structures. It defines the configuration and changing dimensions of the chambers, dynamic cyclic variation in myocardial thickness and the associated valvular motions throughout the cardiac cycle. This technique is useful for recording lateral motion and providing the correct spatial relationship between cardiac structures.
Doppler examination is a valuable adjunct to a complete echocardiographic examination. The basic principle utilizes the changes in frequency when a transmitted ultrasound wave is reflected from a moving surface, allowing measurement of velocity of movement (i.e., blood flow). Doppler velocity recordings (with volumetric flow calculations) provide an integrated picture of cardiac structure, function and adaptation to both normal and abnormal physiology. The proximal great vessels and the pericardium can also be directly visualized.
The rapid and non-invasive acquisition of this information has contributed to exponential application and to potential overutilization. This policy addresses the medically reasonable, necessary and appropriate application of TTE.
Ventricular Function and Cardiomyopathies
Ventricular Function and Cardiomyopathies
Changes in myocardial thickness (hypertrophy and thinning), derived parameters of contractility and in chamber volume and morphology can be quantified and charted over time by TTE. Cardiac responses to changes in volume, chronic pressure excess and therapeutic interventions can be monitored. Recognition of the relative contributions of myocardial and valvular functional anomalies to a clinical presentation is facilitated. TTE aids the recognition of myopathies and their classification into hypertrophic, dilated and restrictive types. Absent clinically documented, discrete (abrupt change in signs and symptoms) episodes of deterioration, it is not generally medically necessary to augment clinical assessments with TTE measurements at more-frequent-than-annual examinations.
Although TTE is used in the assessment of ventricular diastolic function, reproducible pathognomonic findings are not well established. In individuals with signs and/or symptoms suggestive of ventricular dysfunction, the demonstration by TTE of normal systolic function and/or ventricular hypertrophy may suggest the presence of diastolic functional abnormalities.
Hypertensive Cardiovascular Disease
Hypertensive Cardiovascular Disease
Left Ventricular Hypertrophy (LVH) correlates with prognosis in hypertensive cardiovascular disease. In individuals with borderline hypertension, the decision to commit to long-term antihypertensive therapy may be determined by the presence of LVH. TTE (CPT code 93308) may assist the decision to treat and the formulation of a treatment program. Baseline TTE (CPT code 93308) and periodic serial assessment (no more frequently than annually) would be medically appropriate.
Acute Myocardial Infarction and Coronary Insufficiency
TTE can detect ischemic and infarcted myocardium. Regional motion, systolic thickening and mural thinning can be quantified and global functional adaptation assessed. The relative contributions of right ventricular ischemia and/or infarction can be evaluated. Complications of acute infarction (mural thrombi, papillary muscle dysfunction and rupture, septal defects, true or false aneurysm and myocardial rupture) can be diagnosed and their contribution to the overall clinical status placed in perspective. Following an initial TTE in the setting of acute infarction, repetition frequency will typically be dictated by the acute clinical course. Absent clinical deterioration or unclear examination findings, repeat assessment typically includes an evaluation at discharge. Convalescent evaluation at approximately six months and annually thereafter generally provides adequate supplemental data to a thoughtful clinical evaluation. The medical record should document the medical necessity of more frequent TTE assessment.
The role for TTE in the emergency room assessment of individuals presenting with chest pain is in evolution. Absent supporting clinical findings of myocardial dysfunction, this application is considered investigational and will be subjected to medical necessity review.
Exposure to Cardiotoxic Agents (Chemotherapeutic and External)
Exposure to Cardiotoxic Agents (Chemotherapeutic and External)
Measures of myocardial contractility, thinning and dilatation are important in the titration of therapeutic agents with known myocardial toxicity. Baseline assessment, bimonthly during and at six months following therapy is generally considered medically appropriate. Following accidental exposure to known myocardial toxic agents, absent abrupt change in clinical signs and/or symptoms, annual assessment would be considered reasonably medically necessary.
Cardiac Transplant and Rejection Monitoring
Cardiac Transplant and Rejection Monitoring
TTE is an integral part of the cardiac donor selection and donor recipient matching process. Evaluation should focus on analysis of ventricular function and the integrity of valvular performance.
TTE is also incorporated into the management of allograft recipients. Myocardial thickness, refractile properties, contractile patterns and indices, restrictive hemodynamics and the late development of pericardial fluid may alert to a rejection episode. None of these findings has achieved diagnostic sensitivity or specificity. Typically, TTE is performed weekly for the first four to eight weeks following transplant with subsequent decremental frequency. Absent acute rejection episodes, approximately three TTE examinations are typically performed yearly in chronic transplant recipients.
Native Valvular Heart Disease
TTE is also incorporated into the management of allograft recipients. Myocardial thickness, refractile properties, contractile patterns and indices, restrictive hemodynamics and the late development of pericardial fluid may alert to a rejection episode. None of these findings has achieved diagnostic sensitivity or specificity. Typically, TTE is performed weekly for the first four to eight weeks following transplant with subsequent decremental frequency. Absent acute rejection episodes, approximately three TTE examinations are typically performed yearly in chronic transplant recipients.
Native Valvular Heart Disease
TTE is well established as a technique of primary choice for the evaluation of valvular pathology and its effect upon global myocardial function. The relative severity of multi-valve pathologies can be quantified. Visualization of the valve and valvular apparatus facilitates therapeutic decisions when competing therapeutic options exist, especially interventions for mitral stenosis. Absent acute intervention or a discrete change in otherwise stable clinical signs and symptoms, TTE in chronic valvular disease is used to document course over time. Generally, it is not medically reasonable and necessary to repeat these examinations more frequently than annually.
Prosthetic Heart Valves (Mechanical and Bioprostheses)
Prosthetic Heart Valves (Mechanical and Bioprostheses)
TTE assessment soon after prosthetic valve implant is important in establishing a baseline structural and hemodynamic profile unique to the individual and the prosthesis. Size, position, underlying ventricular function and concomitant valve pathologies all impact this unique profile. Reassessment following convalescence (three to six months) is appropriate. Thereafter, absent discretely defined clinical events or obvious change in physical examination findings, annual stability assessment is considered medically reasonable and appropriate.
Acute Endocarditis
Acute Endocarditis
TTE can provide diagnostic information. Larger vegetations can be directly visualized. Valvular anatomy and ventricular function may also be directly assessed. The complications or sequelae of acute infective endocarditis can be detected and monitored over time. Acutely, examination frequency is dictated by the individual clinical course. When the acute process has been stabilized, the frequency of serial TTE evaluation will be dictated by the residual pathophysiology and discrete clinical events, analogous to the serial assessment of chronic valvular dysfunction and/or normally functioning prosthetic valves.
Pericardial Disease
Pericardial Disease
A collage of TTE findings have been found to be reliable indices of cardiac tamponade. TTE can be a valuable adjunct during the removal of pericardial fluid and creation of pericardial windows by balloon techniques. Acutely, clinical status will dictate examination frequency. Absent acute pathophysiology, serial assessment of chronic stable pericardial effusion by TTE is not usually reasonable and medically necessary. TTE is less reliable in the detection of chronic pericardial constriction. Current echocardiographic findings in constrictive pericarditis lack the necessary specificity and sensitivity to be reliable diagnostic aids.
Aortic Pathology
Aortic Pathology
TTE can provide valuable information when acute or chronic aortic pathology is present. However, the posterior window of TEE , coupled with the more posterior position of the thoracic aorta has rendered TEE a more determinative study. Non-invasive TTE remains the study of choice for following chronic aortic pathology when images suitable for serial quantitation can be obtained.
Congenital Heart Disease
Congenital Heart Disease
In children and small adults, TTE provides accurate anatomic definition of most congenital heart diseases. Coupled with Doppler hemodynamic measurements, TTE usually provides accurate diagnosis and non-invasive serial assessment. A technically adequate TTE can obviate the need for preoperative catheterization in select individuals. When the disease process and therapy are stable, serial assessment by TTE requires contemporaneous medical necessity documentation if the frequency exceeds an annual evaluation.
Suspected Cardiac Thrombi and Embolic Sources
Suspected Cardiac Thrombi and Embolic Sources
TTE is particularly sensitive in the detection of ventricular thrombi and potentially embolic material. Limited visualization of atrial interstices and the more peripheral and superior portions of the atria render TTE less sensitive than TEE in the detection of atrial thrombus and potentially embolic material. In individuals with cardiac pathology associated with a high incidence of thromboemboli (valvular heart disease, arrhythmias, especially atrial fibrillation, cardiomyopathies and ventricular dysfunction), TTE usually provides adequate supplemental therapeutic decisional data. It merits emphasis that a negative examination (TTE or TEE) does not exclude a cardiac embolus, and the finding of thrombus or vegetation does not establish a cardiac embolic source. Absent the definition of and serial assessment for regression of potentially embolic material, repeat examinations are not generally medically required to direct clinical decisions.
Cardiac Tumors and Masses
Cardiac Tumors and Masses
Infiltrative and ventricular tumors and masses can be visualized, their extent quantified and their hemodynamic consequences assessed by TTE. Right atrial space occupying masses are usually well visualized by TTE. TEE provides a more detailed view of the left atrium and is more sensitive
in quantifying mass characteristics (solid, cystic, etc.), extensions and attachments. These acute pathologies are not typically followed serially.
Critically Ill and Trauma Patients
in quantifying mass characteristics (solid, cystic, etc.), extensions and attachments. These acute pathologies are not typically followed serially.
Critically Ill and Trauma Patients
There is a role of echocardiography in the management of critically ill patients and trauma victims. The cause of a persistent fever may be elucidated. The diagnosis of suspect aortic or central pulmonary pathology, cardiac contusion or a pericardial effusion may be confirmed.
Pertubations of volume status may be more completely defined and management strategies modified. The frequency of these typically acute studies will be dictated by the exigencies of the clinical milieu.
Ultrasonic equipment is increasingly more compact and portable. Certain highly portable (a.k.a. “hand-held”) scanners possess the same functional capabilities, hence, providing the same diagnostic value as traditional and larger “state of the art” instruments. Other scanners have limited capabilities in terms of providing a permanent record of the examination or reduced functional capability for performing a complete examination. Medicare will not cover studies performed in such a manner that the result constitutes a simple extension of the physical examination. To qualify for Medicare payment, a valid echocardiographic service must meet the following standards, regardless of the size of the instrument used to perform the study:
- Performed for an accepted clinical indication.
- Performed by a properly trained examiner.
- Provide a permanent record of images and findings.
- Provide sufficient information to support diagnostic conclusions in a manner that the results will not require confirmation by repeat examination either by a more qualified examiner or utilizing more sophisticated equipment.
- Provide a complete examination, including all of the services described by the CPT code billed.
- Include a written interpretation and report.
Limitations:
Notice: This LCD imposes diagnosis limitations that support diagnosis to procedure code automated denials. However, services performed for any given diagnosis must meet all of the indications and limitations stated in this policy, the general requirements for medical necessity as stated in CMS payment policy manuals, any and all existing CMS national coverage determinations, and all Medicare payment rules.
As published in CMS IOM 100-08, Section 13.5.1, to be covered under Medicare, a service shall be reasonable and necessary. When appropriate, contractors shall describe the circumstances under which the proposed LCD for the service is considered reasonable and necessary under Section 1862(a)(1)(A). Contractors shall consider a service to be reasonable and necessary if the contractor determines that the service is:
- Safe and effective.
- Not experimental or investigational (exception: routine costs of qualifying clinical trial services with dates of service on or after September 19, 2000, which meet the requirements of the clinical trials NCD are considered reasonable and necessary).
- Appropriate, including the duration and frequency that is considered appropriate for the service, in terms of whether it is:
- Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member.
- Furnished in a setting appropriate to the patient’s medical needs and condition.
- Ordered and furnished by qualified personnel.
- One that meets, but does not exceed, the patient’s medical need.
- At least as beneficial as an existing and available medically appropriate alternative.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.
12X, 13X, 18X, 21X, 22X, 23X, 71X, 73X, 77X, 83X, 85X
Bill Type Note: Code 73X end-dated for Medicare use March 31, 2010; code 77X effective for dates of service on or after April 1, 2010.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances, Revenue Codes are purely advisory; unless specified in the policy, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.
Note: TrailBlazer has identified the Bill Type and Revenue Codes applicable for use with the CPT/HCPCS codes included in this LCD . Providers are reminded that not all CPT/HCPCS codes listed can be billed with all Bill Type and/orRevenue Codes listed. CPT/HCPCS codes are required to be billed with specific Bill Type and Revenue Codes. Providers are encouraged to refer to the CMS Internet-Only Manual Publication 100-04, Claims Processing Manual, for further guidance.
0480, 0483
CPT/HCPCS Codes
|
Note:
|
Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book. The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) require the use of short CPT descriptors in policies published on the Web.
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|
C8929
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TTE w or wo fol w con, Doppler (OPPS)
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|
C8930
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TTE w or w/o contr, cont ECG (OPPS)
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|
93304©
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Echo transthoracic
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|
93306©
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Tte w/doppler, complete
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|
93307©
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Echo exam of heart
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|
93308©
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Echo exam of heart
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|
93320©
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Doppler echo exam, heart
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|
93321©
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Doppler echo exam, heart
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93325©
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Doppler color flow add-on
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93350©
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Echo transthoracic
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93351©
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Stress tte complete
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ICD-9-CM Codes That Support Medical Necessity
The CPT/HCPCS codes included in this LCD will be subjected to “procedure to diagnosis” editing. The following lists include only those diagnoses for which the identified CPT/HCPCS procedures are covered. If a covered diagnosis is not on the claim, the edit will automatically deny the service as not medically necessary.
Medicare is establishing the following limited coverage for CPT/HCPCS codes 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93350, 93351, C8929 and C8930:
Covered for:
|
074.1
|
Epidemic pleurodynia
|
|
074.20–074.23
|
Coxsackie carditis
|
|
086.0
|
Chagas’ disease with heart involvement
|
|
088.81
|
Lyme disease
|
|
093.0
|
Aneurysm of aorta specified as syphilitic
|
|
093.1
|
Syphilitic aortitis
|
|
093.20–093.24
|
Syphilitic endocarditis
|
|
093.81–093.82
|
Other specified cardiovascular syphilis
|
|
093.89
|
Other specified cardiovascular syphilis
|
|
093.9
|
Cardiovascular syphilis unspecified
|
|
098.83–098.85
|
Gonococcal infection of other specified sites
|
|
112.81
|
Candidal endocarditis
|
|
115.03–115.04
|
Infection of Histoplasma capsulatum
|
|
115.13–115.14
|
Infection of Histoplasma duboisii
|
|
130.3
|
Myocarditis due to toxoplasmosis
|
|
135
|
Sarcoidosis
|
|
164.1
|
Malignant neoplasm of heart
|
|
164.8
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Malignant neoplasm of other parts of mediastinum
|
|
198.89
|
Secondary malignant neoplasm of other specified sites
|
|
212.7
|
Benign neoplasm of heart
|
|
238.8–238.9
|
Neoplasm of uncertain behavior of other and unspecified sites and tissues
|
|
239.89
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Neoplasm of unspecified nature of other specified sites
|
|
275.01–275.03
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Disorders of mineral metabolism
|
|
275.09
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Other disorders of iron metabolism
|
|
276.0–276.4
|
Disorders of fluid, electrolyte and acid-base balance
|
|
276.50–276.52
|
Volume depletion
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|
276.69
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Other fluid overload
|
|
276.7–276.9
|
Disorders of fluid, electrolyte, and acid-base balance
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|
277.30
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Amyloidosis, unspecified
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|
277.39
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Other amyloidosis
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|
362.30–362.37
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Retinal vascular occlusion
|
|
368.00
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Amblyopia unspecified
|
|
391.0–391.2
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Rheumatic fever with heart involvement
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|
391.8–391.9
|
Rheumatic fever with heart involvement
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|
392.0
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Rheumatic chorea with heart involvement
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|
393
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Chronic rheumatic pericarditis
|
|
394.0–394.2
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Disease of mitral valve
|
|
394.9
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Other and unspecified mitral valve diseases
|
|
395.0–395.2
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Disease of aortic valve
|
|
395.9
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Other and unspecified rheumatic aortic diseases
|
|
396.0–396.3
|
Diseases of mitral and aortic valves
|
|
396.8–396.9
|
Diseases of mitral and aortic valves
|
|
397.0–397.1
|
Diseases of other endocardial structures
|
|
397.9
|
Rheumatic diseases of endocardium valve unspecified
|
|
398.0
|
Rheumatic myocarditis
|
|
398.90–398.91
|
Other and unspecified rheumatic heart diseases
|
|
398.99
|
Other rheumatic heart diseases
|
|
401.0–401.1
|
Essential hypertension
|
|
401.9
|
Unspecified essential hypertension
|
|
402.00–402.01
|
Malignant hypertensive heart disease
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|
402.10–402.11
|
Benign hypertensive heart disease
|
|
402.90–402.91
|
Unspecified hypertensive heart disease
|
|
403.00–403.01
|
Hypertensive chronic kidney disease, malignant
|
|
403.10–403.11
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Hypertensive chronic kidney disease, benign
|
|
403.90–403.91
|
Hypertensive chronic kidney disease, unspecified
|
|
404.00–404.03
|
Hypertensive heart and chronic kidney disease
|
|
404.10–404.13
|
Hypertensive heart and chronic kidney disease, benign
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|
405.01
|
Malignant renovascular hypertension
|
|
405.09
|
Other malignant secondary hypertension
|
|
405.11
|
Benign renovascular hypertension
|
|
405.19
|
Other benign secondary hypertension
|
|
405.91
|
Unspecified renovascular hypertension
|
|
405.99
|
Other unspecified secondary hypertension
|
|
410.00–410.02
|
Acute myocardial infarction of anterolateral wall
|
|
410.10–410.12
|
Acute myocardial infarction of other anterior wall
|
|
410.20–410.22
|
Acute myocardial infarction of inferolateral wall
|
|
410.30–410.32
|
Acute myocardial infarction of inferoposterior wall
|
|
410.40–410.42
|
Acute myocardial infarction of other inferior wall
|
|
410.50–410.52
|
Acute myocardial infarction of other lateral
|
|
410.60–410.62
|
True posterior wall infarction
|
|
410.70–410.72
|
Subendocardial infarction
|
|
410.80–410.82
|
Acute myocardial infarction of other specified sites
|
|
410.90–410.92
|
Acute myocardial infarction of unspecified site
|
|
411.0–411.1
|
Other acute and subacute forms of ischemic heart disease
|
|
411.81
|
Acute coronary occlusion without myocardial infarction
|
|
411.89
|
Other acute and subacute forms of ischemic heart disease other
|
|
412
|
Old myocardial infarction
|
|
413.0–413.1
|
Angina pectoris
|
|
413.9
|
Other and unspecified angina pectoris
|
|
414.00–414.07
|
Other forms of chronic ischemic heart disease
|
|
414.10–414.12
|
Aneurysm and dissection of heart
|
|
414.19
|
Other aneurysm of heart
|
|
414.2–414.3
|
Other forms of chronic ischemic heart disease
|
|
414.8–414.9
|
Other forms of chronic ischemic heart disease
|
|
415.0
|
Acute cor pulmonale
|
|
415.11–415.12
|
Acute pulmonary heart disease
|
|
415.19
|
Other pulmonary embolism and infarction
|
|
416.0–416.2
|
Chronic pulmonary heart disease
|
|
416.8–416.9
|
Chronic pulmonary heart disease
|
|
417.0–417.1
|
Other diseases of pulmonary circulation
|
|
417.8–417.9
|
Other diseases of pulmonary circulation
|
|
420.0
|
Acute pericarditis in diseases classified elsewhere
|
|
420.90–420.91
|
Other and unspecified acute pericarditis
|
|
420.99
|
Other acute pericarditis
|
|
421.0–421.1
|
Acute and subacute endocarditis
|
|
421.9
|
Acute endocarditis unspecified
|
|
422.0
|
Acute myocarditis in diseases classified elsewhere
|
|
422.90–422.93
|
Other and unspecified acute myocarditis
|
|
422.99
|
Other acute myocarditis
|
|
423.0–423.3
|
Other diseases of pericardium
|
|
423.8–423.9
|
Other diseases of pericardium
|
|
424.0–424.3
|
Other diseases of endocardium
|
|
424.90–424.91
|
Endocarditis valve unspecified
|
|
424.99
|
Other endocarditis valve unspecified
|
|
425.0–425.9
|
Cardiomyopathy
|
|
426.0
|
Atrioventricular block complete
|
|
426.10–426.13
|
Atrioventricular block, other and unspecified
|
|
426.2–426.4
|
Conduction disorders
|
|
426.50–426.54
|
Bundle branch block, other and unspecified
|
|
426.6–426.7
|
Conduction disorders
|
|
427.0–427.2
|
Cardiac dysrhythmias
|
|
427.31–427.32
|
Atrial fibrillation and flutter
|
|
427.41–427.42
|
Ventricular fibrillation and flutter
|
|
427.5
|
Cardiac arrest
|
|
427.60–427.61
|
Premature beats
|
|
427.69
|
Other premature beats
|
|
427.81
|
Sinoatrial node dysfunction
|
|
427.89
|
Other specified cardiac dysrhythmias
|
|
427.9
|
Cardiac dysrhythmia unspecified
|
|
428.0–428.1
|
Heart failure
|
|
428.20–428.23
|
Systolic heart failure
|
|
428.30–428.33
|
Diastolic heart failure
|
|
428.40–428.43
|
Combined systolic and diastolic heart failure
|
|
428.9
|
Heart failure unspecified
|
|
429.0–429.6
|
Ill-defined descriptions and complications of heart disease
|
|
429.71
|
Acquired cardiac septal defect
|
|
429.79
|
Certain sequelae of myocardial infarction not elsewhere classified other
|
|
429.81–429.83
|
Other ill-defined heart diseases
|
|
429.89
|
Other ill-defined heart diseases
|
|
429.9
|
Heart disease unspecified
|
|
431
|
Intracerebral hemorrhage
|
|
434.00–434.01
|
Cerebral thrombosis
|
|
434.10–434.11
|
Cerebral embolism
|
|
434.90–434.91
|
Cerebral artery occlusion
|
|
435.0–435.3
|
Transient cerebral ischemias
|
|
435.8–435.9
|
Transient cerebral ischemias
|
|
436
|
Acute but ill-defined cerebrovascular disease
|
|
440.20–440.24
|
Atherosclerosis of native arteries of the extremities
|
|
440.29
|
Other atherosclerosis of native arteries of the extremities
|
|
441.00–441.03
|
Dissection of aorta
|
|
441.1–441.7
|
Aortic aneurysm and dissection
|
|
441.9
|
Aortic aneurysm of unspecified site without rupture
|
|
444.21–444.22
|
Arterial embolism and thrombosis of arteries of the extremities
|
|
444.81
|
Embolism and thrombosis of iliac artery
|
|
446.1
|
Acute febrile mucocutaneous lymph node syndrome (MLNS)
|
|
446.7
|
Takayasu’s disease
|
|
458.0
|
Orthostatic hypotension
|
|
458.9
|
Hypotension unspecified
|
|
518.4–518.5
|
Other diseases of lung
|
|
518.7
|
Transfusion related acute lung injury (TRALI)
|
|
518.81–518.84
|
Other diseases of lung
|
|
557.0
|
Acute vascular insufficiency of intestine
|
|
593.81
|
Vascular disorders of kidney
|
|
634.60–634.62
|
Abortion complicated by embolism
|
|
635.60–635.62
|
Legally induced abortion complicated by embolism
|
|
636.60–636.62
|
Illegal abortion complicated by embolism
|
|
637.60–637.62
|
Legally unspecified type of abortion complicated by embolism
|
|
638.6
|
Failed attempted abortion complicated by embolism
|
|
673.20–673.24
|
Obstetrical blood-clot embolism
|
|
674.82
|
Other complications of puerperium with delivery with postpartum complication
|
|
674.84
|
Other complications of puerperium
|
|
710.0–710.1
|
Diffuse diseases of connective tissues
|
|
745.0
|
Common truncus
|
|
745.10–745.12
|
Transposition of great vessels
|
|
745.19
|
Other transposition of great vessels
|
|
745.2–745.5
|
Bulbus cordis anomalies and anomalies of cardiac septal closure
|
|
745.60–745.61
|
Endocardial cushion defects
|
|
745.69
|
Other endocardial cushion defects
|
|
745.7–745.9
|
Bulbus cordis anomalies and anomalies of cardiac septal closure
|
|
746.00
|
Congenital pulmonary valve anomaly unspecified
|
|
746.01–746.02
|
Anomalies of pulmonary valve
|
|
746.09
|
Other congenital anomalies of pulmonary valve
|
|
746.1–746.7
|
Other congenital anomalies of heart
|
|
746.81–746.85
|
Other specified anomalies of heart
|
|
746.87
|
Malposition of heart and cardiac apex
|
|
746.89
|
Other specified congenital anomalies of heart
|
|
746.9
|
Unspecified congenital anomaly of heart
|
|
747.0
|
Patent ductus arteriosus
|
|
747.10–747.11
|
Coarctation of aorta
|
|
747.20–747.22
|
Other anomalies of aorta
|
|
747.29
|
Other congenital anomalies of aorta
|
|
747.3
|
Congenital anomalies of pulmonary artery
|
|
747.40–747.42
|
Anomalies of great veins
|
|
747.49
|
Other anomalies of great veins
|
|
759.3
|
Situs inversus
|
|
759.82
|
Marfan syndrome
|
|
780.02
|
Transient alteration of awareness
|
|
780.2
|
Syncope and collapse
|
|
780.60–780.62
|
Fever
|
|
782.5
|
Cyanosis
|
|
785.0–785.3
|
Symptoms involving cardiovascular system
|
|
785.50–785.51
|
Shock without mention of trauma
|
|
785.59
|
Other shock without trauma
|
|
786.05
|
Shortness of breath
|
|
786.09
|
Respiratory abnormality other
|
|
786.50–786.51
|
Chest pain
|
|
786.59
|
Other chest pain
|
|
790.7
|
Bacteremia
|
|
794.31
|
Nonspecific abnormal electrocardiogram (ECG) (EKG)
|
|
807.4
|
Flail chest
|
|
861.00–861.03
|
Heart without mention of open wound into thorax
|
|
861.10–861.13
|
Heart with open wound into thorax
|
|
901.0–901.2
|
Injury to blood vessels of thorax
|
|
901.40–901.42
|
Pulmonary blood vessels
|
|
922.1
|
Contusion of chest wall
|
|
958.0–958.1
|
Certain early complications of trauma
|
|
958.4
|
Traumatic shock
|
|
959.11–959.14
|
Trunk, injury other and unspecified
|
|
959.19
|
Other and unspecified injury of other sites of trunk
|
|
960.7
|
Poisoning by antineoplastic antibiotics
|
|
962.0
|
Poisoning by adrenal cortical steroids
|
|
963.1
|
Poisoning by antineoplastic and immunosuppressive drugs
|
|
965.09
|
Poisoning by other opiates and related narcotics
|
|
972.0–972.1
|
Poisoning by agents primarily affecting the cardiovascular system
|
|
980.3
|
Toxic effect of fusel oil
|
|
986
|
Toxic effect of carbon monoxide
|
|
990
|
Effects of radiation unspecified
|
|
994.0
|
Effects of lightning
|
|
994.8
|
Electrocution and nonfatal effects of electric current
|
|
995.1
|
Angioneurotic edema not elsewhere classified
|
|
996.01
|
Mechanical complication due to cardiac pacemaker (electrode)
|
|
996.02–996.04
|
Mechanical complication of cardiac device, implant and graft
|
|
996.61
|
Infection and inflammatory reaction due to cardiac device implant and graft
|
|
996.71
|
Other complications due to heart valve prosthesis
|
|
996.83
|
Complications of transplanted heart
|
|
997.1
|
Cardiac complications not elsewhere classified
|
|
998.0
|
Postoperative shock not elsewhere classified
|
|
998.51
|
Infected postoperative seroma
|
|
998.59
|
Other postoperative infection
|
|
999.31
|
Infection due to central venous catheter
|
|
999.4
|
Anaphylactic shock due to serum not elsewhere classified
|
|
V12.53
|
Personal history of sudden cardiac arrest
|
|
V42.1
|
Heart replaced by transplant
|
|
V42.2
|
Heart valve replaced by transplant
|
|
V43.3
|
Heart valve replaced by other means
|
|
V58.69
|
Long-term (current) use of other medications
|
|
V59.8
|
Donors of other specified organ or tissue
|
Medicare is establishing the following additional limited coverage for CPT/HCPCS codes 93303, 93304, 93306, 93307 and 93308:
Covered for:
|
V58.11
|
Encounter for antineoplastic chemotherapy and immunotherapy
|
|
|
Note: Use V58.11 to report baseline echocardiography for left ventricular assessment prior to initiating cancer treatment with a known cardiotoxic agent(s).
|
Note: Providers should continue to submit ICD-9-CM diagnosis codes without decimals on their claim forms and electronic claims.