Medicine
Chapter 7
Section 10.1
Echocardiogram
For Dental And Invasive Procedures
Issue Date: May 24, 1998
Copyright: CPT only © 2006 American Medical
Association (or such other date of publication of CPT).
All Rights Reserved.
Revision:
1.0 CPT PROCEDURE CODE RANGE
93303 - 93350
2.0 DESCRIPTION
An echocardiogram is a non-invasive
diagnostic test performed to evaluate the heart’s function. It is able
to monitor the performance of the valves. It can help to diagnose
structural abnormalities in the heart wall, valves, and blood vessels.
It can detect tumors, clots or pericardial effusions (abnormal fluid collection
around the heart). It is sometimes used after a heart attack to
evaluate the cardiac wall motion and function. The most frequent
use of an echocardiogram is for diagnosing or monitoring congenital
heart disease, cardiomyopathies or aneurysms.
3.0 POLICY
3.1 An echocardiogram
is a covered procedure to evaluate the valves and chambers of the
heart, to aid the diagnosis of cardiomyopathies, to detect atrial
tumors or pericardial effusions or to evaluate cardiac wall motion
and function after a heart attack.
3.2 An echocardiogram
is a covered diagnostic procedure for cardiac valvulopathy associated
with ingestion of Pondimin and Redux (Phen-Fen):
3.2.1 After
a thorough medical history and cardiovascular physical examination
reveals a new murmur or symptoms (shortness of breath) of cardiac
problems; or
3.2.2 Before dental procedures in
patients who have been found to have clinically significant valvular
abnormalities. Abnormalities that create the risk for developing
endocarditis include, but are not limited to:
3.2.2.1 Implanted heart valves as a
replacement for their own heart valve.
3.2.2.2 Abnormal native heart valves
(leakage, blockage).
3.2.2.3 Any congenital heart defect
(Ventricular Septal Defect (VSD), Atrial Septal Defect (ASD), Patent
Ductus Arteriosus (PDA), complex anomaly).
3.2.2.4 Dacron or Teflon vascular grafts
or patches over cardiac defects.
3.2.2.5 Mitral valve prolapse - only
if there is significant valve leakage.
3.2.2.6 Pacemakers.
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