Q9957, Injection, perflutren lipid microspheres, per ml
HCPCS/CPT
Prior Authorization
Prior Auth Required
Code explicitly requires prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
- Every page of the record must be legible and include appropriate patient identification information, including complete name and dates of service.
- The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
- The submitted medical record must support the use of the selected ICD-10-CM code(s).
Key Coverage Criteria
- CPT code 93355 is used to report transesophageal echocardiography (TEE) performed during transcatheter intracardiac therapies.
- When contrast is used for a complete TEE procedure (probe placement, image acquisition, interpretation and report), bill CPT code 93312 (HCPCS C8925 for OPPS billing).
- For congenital anomalies, use CPT code 93315 (HCPCS C8926 for OPPS billing) for the complete contrast TEE procedure.
- Hospitals should bill echocardiograms without contrast using the applicable Level 1 CPT code descriptors and guidelines.
- Transthoracic echocardiography (TTE) is covered when the patient's medical record documents medical necessity consistent with the LCD indications for TTE.
- Contrast (contrast-enhanced) echocardiography is covered when conventional echocardiographic studies were inconclusive and contrast enhancement is needed to complete diagnostic evaluation.
8 Active Policies
CGS-L34338, Transthoracic Echocardiography (TTE)
J15
A56781, Billing and Coding: Transthoracic Echocardiography (TTE)
J6
NOVITAS-L35016, Transesophageal Echocardiography (TEE)
JH
NGS-L33577, Transthoracic Echocardiography (TTE)
JK
A56505
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.