Billing and Coding: Echocardiography for Myocardial Perfusion

Echocardiography with ultrasound enhancing agents (UEAs) is covered and considered reasonable and necessary for left ventricular opacification (the sole FDA‑approved cardiovascular use), for assessment of myocardial perfusion in patients with elevated cardiovascular risk presenting with symptomatic angina and known or suspected CAD, and for myocardial viability assessment to guide therapeutic or diagnostic decisions. Coverage requires appropriate medical-record documentation of the indication, methods (including mechanical indices), lab accreditation and operator certification; determinations of reasonable and necessary for off‑label use and frequency are subject to Medicare Administrative Contractor (MAC) review. Billing notes: the contrast supply is billed separately from the echo procedure, while diagnostic injection services are integral to the contrast procedure and are not separately payable.

"Echocardiography performed with an ultrasound enhancing agent (UEA) for left ventricular opacification (LVO) in the setting of cardiovascular disease is reasonable and medically necessary (FDA‑appr..."