To complete a stress echo you have to be able to visualize the wall motion of the heart chambers. If the sonographer cannot visualize these due to body habitus or disease process, she completes the initial echo but does not go on to stress the patient and get post images. The point of taking the second images after exercise is to see the wall motion and identify abnormalities with stressed/exercised. How is this coded if the stress portion is not completed? Is 93351-52 or 93350-52 appropriate?
If there is no stress, then you would code a “regular” echo (93306, 93307, 93308, etc.) instead of the codes you mention above.