Ask Dr. Z

I am auditing stress echocardiograms with color Doppler. The indication is dyspnea on exertion and abnormal EKG. The physician gives the findings of the resting and stress EKG and echocardiogram and then states the heart contractility was normal and that it was an unremarkable stress echocardiogram. However, immediately below this statement he gives the findings of the color Doppler, which showed mild AI, mild MR, and mild TR (which codes to I08.3). The coder I'm auditing is coding I08.3 as the primary diagnosis on the stress echocardiogram and the color Doppler code due to those color flow Doppler findings. My understanding is that a stress echo is designed to measure the effect of stress on the heart, and since the provider has told me the stress echocardiogram was normal these valvular findings are not a response to stress and are incidental. I would revert to the indication to assign the ICD-10-CM code. What is your take?