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2025 CPT code 93351

Stress echocardiogram with complete cardiovascular stress test, including continuous ECG monitoring, supervision, interpretation, and report.

Follow all applicable CPT coding guidelines for echocardiography and cardiovascular stress testing.Document all aspects of the procedure, including the type of stress, the patient's response, and any complications.

Modifiers 26 (professional component) and TC (technical component) may be appended as appropriate. Modifier 51 (multiple procedures) may be used if other related procedures are performed on the same day.

The stress echocardiogram is medically necessary to assess myocardial ischemia (reduced blood flow to the heart muscle) and/or left ventricular function in patients with symptoms suggestive of coronary artery disease or other cardiac conditions.The test is also used to evaluate the effectiveness of treatment and prognosis.

The physician or other qualified healthcare professional is responsible for performing the stress test (including ECG monitoring and supervision), obtaining and interpreting the echocardiogram images, and generating a comprehensive report that includes the patient's response to stress (hemodynamic, electrocardiographic, and echocardiographic).

IMPORTANT:Do not report 93351 with 93015-93018, 93350.Do not report 93351-26 with 93016, 93018, 93350-26.Use 93350 when all professional services of a stress test are not performed by the same physician performing the stress echocardiogram, in conjunction with codes 93016-93018 for the stress test components provided.For the professional component only, use modifier 26. For the technical component only, use modifier TC.If the stress test is not performed, use 93306 or 93307 (depending on Doppler use).

In simple words: This test combines a heart ultrasound (echocardiogram) with a stress test (exercise or medication) to check how well your heart works under pressure. It includes continuous heart monitoring and a doctor's interpretation of the results to identify heart problems.

This CPT code reports a stress echocardiogram performed with a complete cardiovascular stress test.The procedure involves recording echocardiographic images from multiple cardiac windows before, after, and sometimes during stress, induced by treadmill/bicycle exercise or pharmacological agents. Continuous electrocardiographic monitoring, supervision, interpretation, and a physician report are included.The report evaluates stress duration, reasons for stopping, hemodynamic and electrocardiographic responses to stress, and echocardiographic changes.

Example 1: A 60-year-old male presents with chest pain. A stress echocardiogram (93351) is performed to evaluate for coronary artery disease. The patient exercises on a treadmill, and images are obtained at rest, peak exercise, and recovery., A 70-year-old female with a history of hypertension undergoes a pharmacological stress echocardiogram (93351) using dobutamine due to inability to exercise.Images are obtained at rest and at various stages of dobutamine infusion., A 45-year-old presents post-myocardial infarction. A stress echo (93351) is performed to assess left ventricular function and viability. The procedure is performed using a bicycle exercise protocol, with images obtained at rest, peak exercise, and recovery.

Complete medical history, physical examination findings, ECG tracings at rest and during stress, echocardiographic images at rest, during stress, and recovery, medication administered (if applicable), and a detailed interpretation report.

** This code includes the complete cardiovascular stress test, which should not be billed separately.Supply of contrast agent and/or drugs used for pharmacological stress is reported separately.The use of echocardiographic contrast (93352) should be reported separately if used.

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