2025 CPT code 93303
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Imaging - Echocardiography Cardiovascular System Feed
Complete transthoracic echocardiography for confirmed congenital cardiac anomalies.
Modifiers 26 (professional component) and TC (technical component) can be appended as appropriate. Modifier 51 (multiple procedures) may apply if additional echocardiographic procedures are performed during the same session.
Medical necessity is established when there is a clinical indication for evaluating a confirmed congenital heart anomaly. This could include assessing the severity of the defect, monitoring its progression, or evaluating the effectiveness of treatment. The ordering physician must document the medical necessity for the test.
The physician is responsible for performing the echocardiogram, interpreting the images, and generating a written report. This includes prepping the patient, applying gel, placing the transducer, manipulating it to obtain optimal images from various views (subcostal, apical, parasternal, suprasternal), evaluating the heart's movement and blood flow, and identifying and documenting any abnormalities.
In simple words: This test uses sound waves to create pictures of a baby's heart before birth or soon after.The doctor uses a special wand on the chest to get a complete image of the heart's chambers, valves, and blood flow to check for any birth defects.
This code reports a comprehensive transthoracic echocardiogram specifically for patients with confirmed congenital cardiac anomalies.The procedure involves obtaining ultrasonic signals from the heart and great vessels, creating real-time images and/or Doppler ultrasound signal documentation.It includes a complete two-dimensional and M-mode (when performed) examination of the left and right atria, ventricles, aortic, mitral, and tricuspid valves, pericardium, and adjacent portions of the aorta.Appropriate measurements are obtained and recorded.The interpretation and report are included.Additional structures, such as pulmonary veins, pulmonary artery, pulmonic valve, and inferior vena cava, may be visualized and documented.
Example 1: A newborn is diagnosed with a heart murmur. A complete echocardiogram (93303) is performed to confirm the presence of a congenital heart defect, revealing a ventricular septal defect., A child with a history of Tetralogy of Fallot undergoes a follow-up echocardiogram (93303) to assess the effectiveness of prior surgical repair and detect any residual defects., An adult with a known congenital heart defect (e.g., Atrial Septal Defect) presents with symptoms of worsening heart failure. A complete echocardiogram (93303) is performed to evaluate the severity of the defect and assess the need for intervention.
Detailed patient history, including known congenital heart conditions, symptoms, and relevant past medical history.Echocardiogram images and measurements of all visualized structures.A comprehensive written report that includes findings, measurements, and interpretation, signed by the interpreting physician.
** This code should not be used if the congenital heart defect is suspected, but not confirmed on the echocardiographic evaluation or for “simple” congenital anomalies such as patent foramen ovale (PFO) or bicuspid aortic valve. For those cases, you would report a non-congenital echo CPT code (93306–93308).
- Payment Status: Active
- Modifier TC rule: Modifier TC may be appended if only the technical component is reported and not provided by the hospital.
- Specialties:Cardiology, Pediatric Cardiology, Congenital Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Office