Horizon Echocardiography Privileging Program FAQs

Q: What procedures are included in the Horizon Echocardiography Privileging Program?
A: Outpatient transthoracic echocardiography (TTE) and stress echocardiography.

Q: What CPT codes fall under this program?
A: Primary CPT codes for TTE include 93303, 93304, 93306, 93307, and 93308. Add-on codes for TTE include 93320, 93321, and 93325. Stress echocardiography codes include primary code 93350 and 93351, and add-on code 93352.

Q: What are the requirements of this program?
A: This program requires that the performance and interpretation of  TTE and stress echocardiography be limited to providers who are board certified in cardiology by the American Board of Internal Medicine (ABIM), American Board of Pediatrics (ABP) or non-cardiologist providers who are certified by the National Board of Echocardiography (NBE) for TTE and/or stress echocardiography.  In addition, all procedures are to be performed at sites with Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL) accreditation. Sites supervised by a board certified cardiologist must meet this requirement by November 30, 2010.

Q: Are medical necessity determinations required at privileged sites?
A: Yes, all outpatient echocardiography requests require an authorization number obtainable through CareCore National by calling 866-496-6200 or online at www.carecorenational.com.

Q: How does the accreditation process work?
A: All providers and sites wishing to perform and interpret outpatient echocardiography are required to submit a completed application with all required supporting documentation to CareCore National. Applications can be downloaded at www.carecorenational.com/PDFS/HorizonEchoApp.pdf.

Q: When does is the completed application required?
A: Submission of the completed application and supporting documentation should be received by the CareCore National Credentialing Department at 800-918-8924 extension 10190 prior to November 30, 2009. Upon receipt of a completed application, CareCore National will privilege applicants who fulfill all requirements.

Q: Will my site be allowed to bill for performance of medically necessary outpatient echocardiogram without filing a completed privileging application?
A: Any outpatient echocardiography procedure that is billed by a non-privileged site may not be reimbursed regardless of medical necessity.

Q: Where can I obtain an application to participate in the Horizon Echocardiography Privileging Program?
A: An application is available for download by visiting the CareCore National website at www.carecorenational.com/ProviderTools.asp or by clicking here.

Q: How do I inquire about the status of my application to be privileged to provide TEE and stress echocardiography procedures?
A: The status of all echocardiography privileging applications can be addressed by calling the CareCore National Credentialing Department at 800-918-8924 extension 10190.