Summary & Overview
HCPCS C8923: Transthoracic Echocardiography with Contrast, Complete
HCPCS Level II code C8923 designates a complete transthoracic echocardiography study performed in real time using 2D imaging that may include contrast administration or conversion from non-contrast to contrast imaging, and includes M-mode recording when performed. This code matters nationally because transthoracic echocardiography with contrast is a common, guideline-supported diagnostic tool for cardiac structure and function assessment, particularly when image quality is suboptimal without contrast. Payers with coverage practices relevant to this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical context for C8923, typical sites of service, and the service type. The publication presents benchmark information where available, notes of payer coverage patterns and common billing modifiers, and summarizes coding and billing considerations relevant to imaging departments and cardiology practices. The content contextualizes C8923 among related echocardiography services and highlights policy and documentation elements that commonly affect payment and utilization. Data not available in the input will be noted as such where applicable.
Billing Code Overview
HCPCS Level II code C8923 describes transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2D), includes M-mode recording, when performed, complete, without spectral or color Doppler echocardiography. This procedure represents a complete transthoracic echocardiographic study performed using contrast agents when indicated to enhance endocardial border delineation or diagnostic yield.
Service type: Diagnostic cardiac imaging – transthoracic echocardiography (contrast-enhanced, complete, 2D)
Typical site of service: Hospital outpatient department or freestanding echo/cardiology imaging center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old outpatient with a history of ischemic heart disease and new exertional dyspnea is referred from cardiology for transthoracic echocardiography with contrast to better define left ventricular endocardial borders and assess ejection fraction. The patient arrives at the outpatient cardiac imaging center with an order for contrast-enhanced transthoracic echocardiography. The sonographer verifies allergies, obtains IV access, and reviews indications (evaluation of wall motion, suspected cardiomyopathy, or poor acoustic windows). Baseline two-dimensional imaging with m-mode is performed first. Because standard 2D windows provide suboptimal visualization, an echocardiographic contrast agent is administered per facility protocols while continuous real-time imaging is captured. Images are documented and stored. A cardiologist reviews images, performs interpretation, and documents findings, including contrast use, image quality, ejection fraction, regional wall motion, and any complications. The final report is routed to the referring physician and placed in the medical record for decision-making regarding medical management or further testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | When no specific modifier applies; use per payer rules |
22 |