How To Use CPT Code 93316

CPT 93316 describes the procedure of transesophageal echocardiography (TEE) for congenital cardiac anomalies, specifically the placement of the transesophageal probe. This article will cover the description, official definition, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93316?

CPT 93316 can be used to describe the placement of a transesophageal probe during a transesophageal echocardiography (TEE) procedure. This code specifically focuses on the visualization of the heart for any congenital problems using a flexible tube with a transducer at its tip. The provider guides the probe down the throat and into the esophagus to obtain detailed images of the heart.

2. Official Description

The official description of CPT code 93316 is: ‘Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only.’

3. Procedure

  1. The patient is appropriately prepped and anesthetized for the procedure.
  2. The provider inserts a flexible tube with a transducer at its tip into the patient’s throat and guides it into the esophagus.
  3. The transducer generates ultrasound beams to obtain a two-dimensional (2D) image of the heart.
  4. The provider visualizes the heart and its chambers to identify any congenital abnormalities.
  5. This code specifically covers the placement of the transesophageal probe during the procedure.

4. Qualifying circumstances

CPT 93316 is used for patients with congenital cardiac anomalies, which refers to defects or abnormalities in the heart present since birth. The procedure is performed by a provider who is trained in transesophageal echocardiography and has the necessary equipment to place the transesophageal probe. It is important to note that this code should not be reported in conjunction with CPT code 93355.

5. When to use CPT code 93316

CPT code 93316 should be used when the provider performs the placement of a transesophageal probe during a TEE procedure for congenital cardiac anomalies. It is important to ensure that the procedure is accurately documented and meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 93316, the provider must document the following information:

  • Patient’s diagnosis of congenital cardiac anomalies
  • Details of the transesophageal echocardiography procedure
  • Date and duration of the procedure
  • Specific findings or abnormalities observed during the procedure
  • Signature of the performing provider

7. Billing guidelines

When billing for CPT 93316, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the guidelines provided by the payer and accurately report the services provided. Additionally, do not report CPT 93316 in conjunction with CPT code 93355. It is recommended to review the payer’s policies and guidelines for any additional billing requirements or modifiers that may be necessary.

8. Historical information

CPT 93316 was added to the Current Procedural Terminology system on January 1, 1997. There have been no updates or changes to the code since its addition.

9. Examples

  1. A pediatric cardiologist performing the placement of a transesophageal probe during a TEE procedure to visualize the heart for congenital cardiac anomalies in an infant.
  2. An adult patient undergoing a TEE procedure for the placement of a transesophageal probe to assess congenital cardiac abnormalities.
  3. A cardiac surgeon utilizing a transesophageal probe during a TEE procedure to visualize the heart for congenital cardiac anomalies in a teenager.
  4. A provider performing the placement of a transesophageal probe during a TEE procedure to assess congenital cardiac abnormalities in a young adult.
  5. A provider conducting a TEE procedure with the placement of a transesophageal probe to visualize the heart for congenital cardiac anomalies in an elderly patient.
  6. A provider performing the placement of a transesophageal probe during a TEE procedure to assess congenital cardiac abnormalities in a pregnant patient.
  7. A provider utilizing a transesophageal probe during a TEE procedure to visualize the heart for congenital cardiac anomalies in a patient with a history of heart disease.
  8. A provider conducting the placement of a transesophageal probe during a TEE procedure to assess congenital cardiac abnormalities in a patient with a family history of heart defects.
  9. An interventional cardiologist performing a TEE procedure with the placement of a transesophageal probe to visualize the heart for congenital cardiac anomalies in a patient prior to a cardiac intervention.
  10. A provider utilizing a transesophageal probe during a TEE procedure to assess congenital cardiac abnormalities in a patient with symptoms of heart failure.

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