Coding Stress Echocardiogram: 93350 vs 93351

How should stress echo's be coded?

Assume patient is attached to EKG leads, runs on a treadmill, then lays on bed and gets scanned. Physician is there to supervise the test, dictates report for EKG portion and then dictates a report for echo portion.

These are the possibilities using medicare rates:

Office:

93015 (stress EKG) + 93350 (Stress Echo Images) = $371.75

Hospital:

93016,93018 (Stress EKG Interpretation and Report) + 93350-26 (Professional Component of stress echo) = $117.89

vs

Office:

93351 (Stress Echo Complete) = $330.35

Hospital:

93351-26 (Stress Echo Professional) = $133.05

When would you select 93350 vs 93351?

Coding Stress Echocardiogram: 93350 vs 93351