Additions to the Self-Referral Payment Policy List

Date Issued: 7/31/2014

Effective immediately, the following updates have been made to the HIP Outpatient Diagnostic Imaging Self-Referral Payment Policy list:

  • The CPT-4 code 93312 – transesophageal echocardiography – can now be performed by the following specialties:
  • Cardiologists (cardiovascular disease, interventional cardiologists and cardiac electrophysiologists)
  • Pediatric cardiologists
  • The specialty of oral and maxillofacial surgeons can now perform the following CPT codes:
  • 70100, 70110, 70140, 70150 – mandible and facial bone imaging
  • 70300, 70310, 70320 – teeth imaging
  • 70328, 70330 – TMJ imaging
  • 70350 – cephalogram, orthodontic
  • 70355 – orthopantogram

Note: The HIP Outpatient Diagnostic Imaging Self-Referral Payment Policy is designed to promote appropriate use of diagnostic imaging by primary care physicians, specialty physicians and other health care professionals in office settings. This payment policy describes the minimum accreditation and certification requirements for ultrasound, echocardiography and nuclear medicine. It assumes board certification (by an American Board of Medical Specialties) in the appropriate provider specialty.