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Official Description

Transthoracic echocardiography for congenital cardiac anomalies; complete

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Transthoracic echocardiography (TTE) is a non-invasive imaging technique that employs ultrasonic sound waves to create visual representations of the heart and its major blood vessels. This procedure is particularly significant for patients with congenital cardiac anomalies, as it allows for a detailed assessment of the heart's structure and function. During a TTE, sound waves are emitted from a transducer placed on the chest, which then reflect off the heart and surrounding structures. These reflected sound waves are converted into electrical signals that are displayed as images on a computer screen, providing real-time visualization of the heart's anatomy and movement. The complete transthoracic echocardiogram, as indicated by CPT® Code 93303, encompasses a thorough evaluation of both the left and right atria, left and right ventricles, the aortic, mitral, and tricuspid valves, the pericardium, and adjacent portions of the aorta. This comprehensive approach ensures that all relevant cardiac structures are assessed, facilitating accurate diagnosis and management of congenital heart defects. The use of M-mode recording within the echocardiogram further enhances the examination by providing specific time-motion information, which is crucial for precise cardiac measurements, such as the thickness of the septal walls and the timing of valve movements. Overall, TTE serves as an essential tool in the diagnosis and monitoring of congenital cardiac conditions, offering valuable insights into the heart's functionality and structural integrity.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The complete transthoracic echocardiography (TTE) procedure, represented by CPT® Code 93303, is indicated for patients with congenital cardiac anomalies. This imaging technique is utilized to evaluate various symptoms and conditions associated with these anomalies, ensuring a comprehensive assessment of the heart's structure and function.

  • Congenital Cardiac Anomalies - Patients diagnosed with structural heart defects present at birth, which may affect the heart's chambers, valves, and major vessels.
  • Assessment of Cardiac Function - Evaluation of the heart's ability to pump blood effectively, which may be compromised due to congenital defects.
  • Monitoring of Existing Conditions - Follow-up imaging for patients with previously diagnosed congenital heart defects to assess any changes in cardiac structure or function over time.

2. Procedure

The procedure for a complete transthoracic echocardiogram involves several key steps to ensure a thorough evaluation of the heart's anatomy and function.

  • Step 1: Patient Preparation - The patient is positioned comfortably, typically lying on their left side, to optimize the acoustic window for imaging. The skin on the chest is prepared, and electrodes may be placed to monitor the heart's electrical activity during the procedure.
  • Step 2: Application of Gel and Transducer Placement - A conductive gel is applied to the chest to facilitate the transmission of sound waves. The ultrasound transducer is then placed on various locations on the chest to capture multiple views of the heart.
  • Step 3: Image Acquisition - The sonographer or physician performs real-time ultrasound scanning, obtaining two-dimensional images of the heart. This includes capturing images of the left and right atria, left and right ventricles, and the valves, as well as the pericardium and adjacent structures such as the aorta and pulmonary vessels.
  • Step 4: M-Mode Recording - Selective M-mode recording is utilized to provide detailed time-motion information. This technique allows for precise measurements of cardiac structures, such as septal wall thickness and valve timing, by displaying depth along the vertical axis and time along the horizontal axis.
  • Step 5: Image Review and Reporting - After the images are captured, they are reviewed for quality and completeness. A comprehensive report is generated, detailing the findings from the echocardiogram, which includes assessments of all evaluated cardiac structures.

3. Post-Procedure

After the completion of the transthoracic echocardiogram, the patient may resume normal activities immediately, as the procedure is non-invasive and typically does not require any recovery time. The images and data collected during the echocardiogram are analyzed by a qualified healthcare professional, who will interpret the results and provide a report. This report may include recommendations for further evaluation or management based on the findings. Patients may be advised to follow up with their healthcare provider to discuss the results and any necessary next steps in their care plan.

Short Descr ECHO TRANSTHORACIC
Medium Descr COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY
Long Descr Transthoracic echocardiography for congenital cardiac anomalies; complete
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 6 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic cardiovascular services apply...
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) I3C - Echography/ultrasonography - heart
MUE 1
CCS Clinical Classification 193 - Diagnostic ultrasound of heart (echocardiogram)

This is a primary code that can be used with these additional add-on codes.

93319 Add-on Code Resequenced Code MPFS Status: Active Code APC N 3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular septum) and function, when performed (List separately in addition to code for echocardiographic imaging)
93320 Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); complete
93321 Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); follow-up or limited study (List separately in addition to codes for echocardiographic imaging)
93325 Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography)
93356 Add-on Code Resequenced Code MPFS Status: Active Code APC N Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (List separately in addition to codes for echocardiography imaging)
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
GC This service has been performed in part by a resident under the direction of a teaching physician
GA Waiver of liability statement issued as required by payer policy, individual case
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
GZ Item or service expected to be denied as not reasonable and necessary
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
63 Procedure performed on infants less than 4 kg: procedures performed on neonates and infants up to a present body weight of 4 kg may involve significantly increased complexity and physician or other qualified health care professional work commonly associated with these patients. this circumstance may be reported by adding modifier 63 to the procedure number. note: unless otherwise designated, this modifier may only be appended to procedures/services listed in the 20100-69990 code series and 92920, 92928, 92953, 92960, 92986, 92987, 92990, 92997, 92998, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93452, 93505, 93563, 93564, 93568, 93569, 93573, 93574, 93575, 93580, 93581, 93582, 93590, 93591, 93592, 93593, 93594, 93595, 93596, 93597, 93598, 93615, 93616 from the medicine/ cardiovascular section. modifier 63 should not be appended to any cpt codes listed in the evaluation and management services, anesthesia, radiology, pathology and laboratory, or medicine sections (other than those identified above from the medicine/cardiovascular section).
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
ET Emergency services
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
U6 Medicaid level of care 6, as defined by each state
X2 Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2011-01-01 Changed Medium description changed.
1997-01-01 Added First appearance in code book in 1997.
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