HCPCS Procedure: C8921

Name of the Procedure:

Common Names:

• Transthoracic Echocardiography with Contrast
• TTE with Contrast

Technical/Medical Terms:

• Echocardiographic Imaging
• Non-invasive Cardiac Ultrasound

Summary

Transthoracic echocardiography (TTE) with contrast is a diagnostic imaging procedure used to create detailed pictures of the heart. The procedure involves using ultrasound waves, and sometimes a special contrast agent, to enhance the images. This helps in detecting congenital cardiac anomalies. It can be performed without contrast at first, and then followed by contrast if needed.

Purpose

TTE with contrast helps in diagnosing congenital heart conditions—anomalies present from birth. The goals are to provide clearer images for accurate diagnosis, enabling more effective treatment plans, and to monitor the heart's function and structure.

Indications

• Symptoms like chest pain, shortness of breath, or palpitations.
• Known or suspected congenital heart defects.
• Abnormal findings in other diagnostic tests (e.g., ECG, chest X-ray).

Preparation

• Fasting may not be required, but follow the specific advice of your healthcare provider.
• Inform your doctor about any medications being taken; some adjustments may be necessary.
• No special pre-operative tests are generally required, but prior imaging studies may be reviewed.

Procedure Description

1. The patient lies on an examination table, and a gel is applied to the chest area.
2. A transducer (ultrasound probe) is moved across the chest to capture images of the heart.
3. Initially, images are taken without the contrast agent.
4. If necessary, a contrast agent is injected intravenously to enhance image quality.
5. Additional images are obtained after the contrast is administered.
6. The procedure may include Doppler imaging to assess blood flow within the heart.

Duration

The procedure typically lasts 30 to 60 minutes.

Setting

The procedure is usually performed in a hospital’s echocardiography lab or an outpatient clinic.

Personnel

• Cardiologist or Cardiac Sonographer: Performs the procedure.
• Nurse or Technician: Assists with patient preparation and administration of contrast.

Risks and Complications

• Common Risks: Minor discomfort from the transducer pressing on the chest.
• Rare Risks: Allergic reaction to the contrast agent, though this is uncommon and manageable.

Benefits

• Provides detailed images of the heart.
• Enhances diagnostic accuracy for congenital heart anomalies.
• Non-invasive with minimal discomfort.
• Immediate results, aiding in quick clinical decisions.

Recovery

• No recovery time required; patients can typically resume normal activities immediately.
• Follow-up appointments might be scheduled based on findings.

Alternatives

• Other imaging techniques like MRI or CT scans.
• Pros: MRI provides detailed soft tissue images without radiation.
• Cons: MRI and CT scans may be more expensive and involve longer imaging times.

Patient Experience

• The procedure is generally painless, though there might be slight discomfort from the transducer.
• Patients may feel a cold sensation from the gel and possibly a brief warming sensation from the contrast agent, if used.
• The healthcare team will ensure comfort and provide pain management if needed.