Ask Dr. Z

This issue has been an ongoing discussion regarding how the hospital should bill for echo stress with EKG tracings. Current practice for the facility is to charge (bill) 93350 for the echo portion and 93017 for the tracings. There is some confusion if the hospital should be billing 93351 instead. The facility believes that 93351 is physician billing only. Code 93351 is a combined code of the stress echo and the EKG tracings. Can you provide clarification and recommend how the hospital should bill for this procedure? My understanding is that it should be billed with CPT code 93351 when same physician supervises and interrupts the echo and stress EKG. It is noted in your 2017 Dr. Z coding books that the recommendation of the AHA is for hospitals to use 93351 and not the separate codes. However CPT Assistant states: "In the facility setting, CPT code 93350 is always used to report the performance and interpretation of a stress echocardiogram since the alternative stress echocardiography code 93351 is reportable only in the non-facility setting."