Billing and Coding: Transthoracic Echocardiography (TTE)

This billing and coding guidance requires valid ICD-10 diagnosis coding, appropriate reporting of referring/ordering physician name and NPI when required, and specific documentation (assessment, history, test results, signed records) for transthoracic echocardiography claims. Use of ABN-related modifiers (-GA, -GX, -GZ, -GY) has defined effects (automatic denials for several modifiers and ABN/form requirements for -GA), and echocardiograms under the CAMZYOS REMS program are limited to patients with NYHA Class II–III obstructive hypertrophic cardiomyopathy (I42.1) and must be billed with modifier KX and meet REMS requirements.

"Echocardiograms performed as part of the CAMZYOS REMS program are covered when billed with modifier KX and all REMS program requirements are met for patients with NYHA Class II–III obstructive hype..."

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