Summary & Overview
HCPCS C8922: Transthoracic Echocardiography with Contrast for Congenital Anomalies, Limited/Follow-up
HCPCS Level II code C8922 designates a transthoracic echocardiography exam using contrast — or an exam performed without contrast followed by contrast — targeted to evaluate congenital cardiac anomalies in a follow-up or limited study context. Nationally, this code captures focused echocardiographic imaging distinct from comprehensive studies and supports clinical management of congenital heart disease across care settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent of the code, typical sites of service where it is performed, and the procedural scope that distinguishes it from full diagnostic transthoracic echocardiography. The publication also summarizes common billing modifiers associated with HCPCS claims for similar services and outlines the clinical scenarios in which a limited or follow-up contrast study is appropriate for congenital anomalies.
This national summary is intended to help billing managers, clinical leaders, and revenue cycle staff understand coding classification, expected service context, and the topics covered in deeper sections of the publication, including benchmarks, payer policy considerations, and operational implications. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code C8922 describes a transthoracic echocardiography study performed with contrast, or performed first without contrast and then followed with contrast, specifically for congenital cardiac anomalies. The code is designated for follow-up or limited studies, indicating a focused imaging exam rather than a comprehensive diagnostic echocardiogram.
Service Type: Echocardiography (transthoracic) with contrast or sequential without then with contrast, limited/follow-up study
Typical Site of Service: Hospital outpatient imaging departments, ambulatory imaging centers, and specialized cardiac diagnostic clinics
Clinical & Coding Specifications
Clinical Context
A pediatric patient with a history of repaired ventricular septal defect presents to cardiology clinic for interval surveillance of residual shunt and right ventricular size. The patient is referred for a transthoracic echocardiogram with contrast to better define intracardiac anatomy and assess for residual communications. On the day of service, the cardiac sonographer obtains focused transthoracic images including 2D, M-mode, Doppler and color flow. After initial non-contrast imaging is obtained, agitated saline or ultrasound contrast agent is administered intravenously and contrast-enhanced imaging is performed to enhance endocardial border definition and to evaluate shunt physiology. The study is coded as a follow-up or limited transthoracic echocardiography with contrast when the examination targets specific congenital cardiac anomalies rather than a complete adult echocardiographic study. The typical workflow includes pre-procedure verification, IV access placement for contrast, image acquisition by sonographer, preliminary interpretation by the reading cardiologist, and final report generation. Typical sites of service are outpatient pediatric cardiology clinics or hospital-based outpatient imaging centers; the procedure can also occur in inpatient pediatric cardiology wards when clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no special modifier applies |