How To Use CPT Code 93315

CPT 93315 describes the procedure of transesophageal echocardiography (TEE) for congenital cardiac anomalies, including probe placement, image acquisition, interpretation, and report. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93315?

CPT 93315 can be used to describe the performance of transesophageal echocardiography (TEE) for congenital cardiac anomalies. This procedure involves the placement of a probe with a transducer at its tip into the esophagus to obtain detailed images of the heart. The provider then interprets the anatomy, dynamics, and function of the heart, as well as the blood flow through the blood vessels and valves. The procedure also includes the acquisition of images and the preparation of a report detailing the findings.

2. Official Description

The official description of CPT code 93315 is: ‘Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation, and report.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider inserts a flexible tube with a transducer at its tip into the patient’s esophagus.
3. The probe generates ultrasound to obtain two-dimensional images of the heart.
4. The provider interprets the anatomy, dynamics, and function of the heart, as well as the blood flow through the blood vessels and valves.
5. The provider prepares a report summarizing the findings.

4. Qualifying circumstances

CPT 93315 is performed for patients with congenital cardiac anomalies, which are defects or abnormalities in the heart present since birth. The procedure is typically performed by a provider who is experienced in transesophageal echocardiography and has the necessary equipment and expertise to perform and interpret the procedure accurately.

5. When to use CPT code 93315

CPT code 93315 should be used when a provider performs transesophageal echocardiography for congenital cardiac anomalies, including probe placement, image acquisition, interpretation, and report. It is important to note that CPT code 93315 should not be reported in conjunction with CPT code 93355.

6. Documentation requirements

To support a claim for CPT 93315, the provider must document the following information:

• Patient’s medical history and indication for the procedure
• Details of the probe placement and image acquisition
• Interpretation of the anatomy, dynamics, and function of the heart
• Assessment of blood flow through the blood vessels and valves
• Summary of the findings in a report

7. Billing guidelines

When billing for CPT 93315, it is important to ensure that the procedure includes probe placement, image acquisition, interpretation, and report. Modifier TC should be appended when reporting only the technical component, and modifier 26 should be appended when reporting only the professional component. It is also important to note that CPT code 93315 should not be reported in conjunction with CPT code 93355.

8. Historical information

CPT code 93315 was added to the Current Procedural Terminology system on January 1, 1997. There have been no updates to the code since its addition.

9. Examples

1. A pediatric cardiologist performs transesophageal echocardiography for a newborn with a suspected congenital heart defect.
2. An adult patient with a history of congenital heart disease undergoes transesophageal echocardiography to assess the function of their repaired heart.
3. A provider performs transesophageal echocardiography on a patient with suspected valve abnormalities.
4. A patient with a family history of congenital cardiac anomalies undergoes transesophageal echocardiography as a precautionary measure.
5. A provider performs transesophageal echocardiography on a patient with unexplained symptoms of heart failure.
6. An elderly patient with a known congenital heart anomaly undergoes transesophageal echocardiography to monitor the progression of their condition.
7. A provider performs transesophageal echocardiography on a patient with suspected abnormalities in the structure of their heart.
8. A patient with a history of congenital heart disease undergoes transesophageal echocardiography to assess the effectiveness of their treatment.
9. A provider performs transesophageal echocardiography on a patient with suspected blood flow abnormalities in their heart.
10. An adult patient with a family history of congenital cardiac anomalies undergoes transesophageal echocardiography as part of a comprehensive cardiovascular evaluation.