Transesophageal Echocardiography (TEE) CODING NOTES

  2011 Transesophageal Echo CPT® Codes:

  93312 TEE with 2-D, M-mode, probe placement, image acquisition, interpretation and report

  93313 TEE probe placement only

  93314 TEE image acquisition, interpretation, and report only

  93315 TEE for congenital anomalies with 2-D, M-mode, probe  placement, image acquisition, interpretation and report

  93316 TEE for congenital anomalies, probe placement only

  93317 TEE for congenital anomalies, image acquisition, interpretation and report only

  93318 TEE for monitoring purposes, ongoing assessment of cardiac pumping function on an immediate time basis



  2011 Doppler Echocardiography CPT® Codes:

  93320 Doppler echo, pulsed wave and/or spectral display

  93321 Doppler echo, pulsed wave and/or spectral display, follow-up or limited study

  93325 Doppler echo, color flow velocity mapping

v The Doppler echo codes, if performed, may be reported with TEE codes: 93312, 93314, 93315, and 93317.



  For coding purposes, there are two parts to the TEE service:

1. Placement of the transesophageal probe (transducer)

2. Image acquisition, interpretation, and report



  The complete transesophageal echocardiogram service, including both probe placement and image acquisition/interpretation, is reported with code 93312.

  Probe placement only is reported with code 93313.

  The image acquisition/interpretation only is reported with code 93314.



  Physicians use codes 93312, 93313, and/or 93314 to report professional services if the test is performed in a hospital or other facility where the  physician cannot bill globally.

  Modifier -26 (professional component) is appended to the appropriate code

  Codes 93313 and 93314 should never be billed together.

v If both services are provided, code 93312 is reported.

  Hospitals should report TEE procedures using code 93312 (the complete service).

  Codes 93313 and 93314 are not used for hospital billing.

  Transesophageal echo is frequently used to monitor patients undergoing cardiac surgery and is reported with code 93318.




o The following are indications for which transesophageal echocardiography (TEE) can be performed at least once:

  Limited transthoracic echo window

  Detection of embolic source or intracardiac shunting when TTE is inconclusive

  Examples: atrial septal defect, ventricular septal defect, patent foramen ovale, aortic cholesterol plaques, thrombus in cardiac chambers, valve vegetations, tumor

  Evaluation of embolic events when there is an abnormal TTE, abnormal ECG, and a history of atrial fibrillation

  Need to clarify pathology of the atria/atrial appendage, aorta, mitral/aortic valve beyond the information that other imaging studies have provided



  Evaluation of cardiac valve dysfunction

  Differentiation of tricuspid from bicuspid aortic valve

  Congenital abnormalities

o The need for repeat TEE studies is based upon findings in the original study
and documentation of the way in which repeat studies will affect patient management:

o TEE is not particularly sensitive for left ventricular assessment since this chamber lies farther from the TEE probe than in transthoracic echo

  Exceptions: the base of the heart in evaluating asymmetric septal hypertrophy or membranous ventricular septal defect