Summary & Overview
HCPCS C8924: Transthoracic Echocardiography with Contrast, Real-Time 2D
HCPCS Level II code C8924 designates transthoracic echocardiography performed with contrast (or without contrast followed by with contrast), captured in real-time 2D with image documentation and M-mode when performed, including follow-up or limited studies. This imaging code is widely used for enhanced visualization of cardiac structures and function, particularly when standard transthoracic imaging is inconclusive. Nationally, contrast-enhanced transthoracic echocardiography supports diagnostic accuracy for structural heart disease, wall motion assessment, and intracardiac shunt evaluation, making the code relevant across hospital outpatient departments and ambulatory imaging centers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for C8924, typical sites of service, and the types of encounters that generate this billing code. The publication summarizes common billing practices, commonly applied modifiers (listed separately), and what to expect in terms of service documentation requirements. It also outlines benchmarking and policy topics relevant to payers and providers, including utilization patterns and coverage considerations at a national level. Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, or related codes is noted where applicable.
Billing Code Overview
HCPCS Level II code C8924 describes a transthoracic echocardiography with contrast, or a study performed without contrast followed by with contrast, captured in real-time with image documentation (2D) and including M-mode recording when performed. The description also covers follow-up or limited studies.
Service type: Diagnostic cardiac imaging — transthoracic echocardiogram with contrast, real-time 2D
Typical site of service: Hospital outpatient imaging departments, hospital-based cardiology suites, and freestanding outpatient imaging centers where transthoracic echocardiography is performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of ischemic heart disease and new exertional dyspnea is referred from cardiology for transthoracic echocardiography with contrast to better delineate endocardial borders and assess left ventricular function. The outpatient encounter begins with nursing triage and verification of identity and indications. The sonographer performs a standard 2-D transthoracic echocardiogram with M-mode recordings. Initial images without contrast demonstrate suboptimal endocardial definition; per protocol the sonographer administers an FDA‑approved echocardiographic contrast agent and acquires contrast-enhanced real-time 2-D images with documentation. The cardiologist reviews images, compares with prior studies, documents quantitative left ventricular ejection fraction and wall motion, and prepares a final report. The study is performed in an outpatient imaging center or hospital-based echocardiography lab with appropriate resuscitation equipment available for contrast administration adverse events. Billing uses HCPCS Level II code C8924 to reflect transthoracic echocardiography with contrast or without followed by with contrast, real-time with image documentation (2-D), including M‑mode when performed, and may represent a follow-up or limited study when clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing physician's interpretation/report separately from facility technical component. |