TEE CPT Code (2022) Description, Guidelines, Reimbursement, Modifiers & Examples

TEE CPT code 93318 (Transesophageal Echocardiography) may be used to monitor a patient’s heart activity during surgery or another operation. Pulsed wave Doppler and color flow mapping services offer additional codes that can be used with the TEE code when reporting their data.

CPT 93318 Summary

CTP code 93320: Doppler echocardiography with spectral display, pulsed wave, and continuous-wave; comprehensive

TEE is a diagnostic tool by cardiologists because it uses an endoscope with an embedded ultrasound transducer to obtain three-dimensional pictures of the heart and its major arteries and spectral and color doppler data.

An endoscope is utilized instead of a transthoracic echo probe to better look at the heart. TEE may use when regular transthoracic echo data is insufficient to answer a clinical question or when a practitioner needs to examine the heart more thoroughly. 

The internal anatomy of the heart can be photographed or recorded (the chambers, valves, and significant veins). The following TEE codes may use to diagnose congenital cardiac abnormalities:

CTP code 93315 may use to gather images, analyze them, and report on the outcomes of congenital heart disease. In CTP code 93316, only transesophageal probes can implant. Under CTP code 93317, only the processes for collecting, analyzing, and reporting on photographs may protect.”

Cardiac Echocardiography with Contrast OPPS Instructions Hospitals should bill for echocardiograms with contrast using the HCPCS codes listed in table 14 below. Hospitals should additionally report the HCPCS codes for the contrast agents used in echocardiograms in the appropriate units. 

When transthoracic imaging is ineffective or burdensome, transesophageal echocardiography (TEE) imaging may be possible. High-resolution probes can detect irregularities that conventional diagnostic procedures might overlook in many circumstances.

As a result, the photographs produced by these gadgets have improved in quality.

In the following cases (see Covered ICD-10 Codes), transesophageal echocardiography may be declared medically necessary:

  • The mitral valves of cardiac implants, for example, are examined.
  • The results of an arrhythmia assessment may influence treatment options for patients with specific heart arrhythmias [atrial fibrillation, atrial flutter]. 
  • Transthoracic and transesophageal echocardiography can be used in tandem to detect a left atrial thrombus.

The following items will discover:

  • the aorta may divide
  • Atrioventricular septal defect
  • Congenital heart disease occurs when a newborn is born with a heart defect (CHD).
  • The left atrium is a common location of thrombosis or embolism.
  • Heart invaders, tumors, and masses
  • Regurgitation of the mitral valve
  • Endocarditis is frequent in vegetative patients.
  • A surgical manual for evaluating left ventricular function
  • Transthoracic echo is insufficient for numerous reasons:
  • lung disease (COPD), chest wall malformation
cpt code for tee with cardioversion

TEE CPT Code Description

Call 99302 when a new problem or complication emerges that necessitates the development of a new care strategy. (Requires a detailed interval history, a thorough examination, and moderate to high complexity medical decision-making). 

This code would be acceptable for a patient recovering from hip surgery in a nursing home with a stroke. According to the CPT manual, “The most prevalent grounds for referrals include complications or new conditions, as well as a significant change in status.

 A new approach to health care is needed.” TTE can also provide diagnostic information, such as direct visualization of larger vegetations and an assessment of the structure and function of the heart valves. Acute infective endocarditis has consequences that can be diagnosed and tracked over time. 

At the most basic level, the frequency of exams may determine by the particular treatment course. After the initial process has stabilized, serial TTE evaluations will define by residual pathophysiology and different clinical occurrences, similar to how chronic valvular dysfunction and normally functioning prosthetic valves may assess serially.

The CPT code for the procedure will enter here.

 An anesthesiologist (specialty number 05) must submit CPT codes 93312, 93313, 93314, 93316, 93317, 93320, *93321, 93325, and/or 93799 for intraoperative TEE. This code can only use during the intraoperative period if another physician conducts and invoices CPT 93314.

If an anesthesiologist provides intra-operative TEE during non-cardiac surgical procedures, the Contractor must have access to the patient’s medical information (05). During cardiac surgical operations, CPT codes 00560 – 00580 may use for heart surgical anesthetic. 

The local Medicare carrier may deny the claim if the readmission is for the same medical condition and happens within 30 days of release, according to Judy Richardson, senior consultant at Hill and Associates, a physician coding and compliance consulting firm in Wilmington NC.

Because regular intraoperative monitoring (TEE CPT Code 93318) is not medically necessary, it will reject. Because Medicare uses this code for readmissions, Richardson advocates requesting a review if the claim may deny.

Echocardiography is a non-invasive way of viewing the outlines, motions, and size of heart structures that uses pulsed high-frequency sound waves. Ultrasonic sound waves target and reflect cardiac systems. Echoes are displayed and recorded on a monitor and tape or digital media using e

This test can detect numerous cardiac problems, examining the heart’s valves and chambers in great detail. Unlike a transthoracic echo, an endoscope can put the echo probe into the heart to see it better. 

Internal images of the heart (the chambers, valves, and main vessels) can be taken on film or digitally preserved. When typical transthoracic echo data are insufficient to explain a clinical question or when the practitioner wishes to examine the heart more intimately, TEE will use. The transesophageal echocardiography codes for congenital cardiac defects are as follows:

Transesophageal echocardiography for congenital heart abnormalities 93315 includes probe positioning, image capture, processing, and reporting. In 93316, only transesophageal probe insertion may permit. Only the procedures of gathering, analyzing, and reporting photographs will protect under 93317.

TEE CPT Code Billing Guidelines

Many payers consider the complete monitoring TEE CPT Code 93318 a non-payable service or bundled with anesthetic treatments. As with any record, the anesthesiologist must specify whether the research is for diagnostic or monitoring purposes.

 TEE studies labeled “diagnostic for monitoring” or “diagnostic TEE studies” that lack the required written report and audits will not accept relevant photographs. In the case of CPT 93312, repetitive cardiac function assessments will need to guide ongoing care, and this code will use for that purpose. 

Using the TEE CPT Code 93318 will not create any permanent images. Modifiers will advise using. The 99313-59 code may record and pay for diagnostic procedures involving simply the probe.

TEE may use in both percutaneous and surgical cardiac procedures. TEE can guide shunt creation, septation device installation, valvular plastic surgery, and replacement when other techniques cannot accurately assess the surgical result. 

The structural integrity and anatomical form of the pulmonary vascular anastomoses are critical in lung or heart-lung transplantation. A TEE can help surgeons make decisions during surgery.

A Medicare payment for the professional component of intraoperative TEE can be justified when the procedure aids in optimal surgical performance or serves a diagnostic role. The physician who performs the process must provide a complete interpretation and written report, as well as images obtained in the same manner as other echocardiographic services.

If it is evident that the patient would be difficult to image due to documented co-morbidities, code 796.4 will use. Second, diagnostic/therapeutic infusions and introduction procedures (90760, 91761, 91762, 91763, 91764, and so on) may be part of a contrast process and cannot charge separately.

It will not advise that all echocardiography patients get intravenous contrast agents. Excessive use will monitor.

TEE CPT Code Modifiers 

Modifier 59 may include the TEE code if the operation’s anesthesiologist is also performing another surgery. It suggests that the TEE is distinct from the anesthetic service.

Whether thorough or limited, echocardiographic study reports must include an evaluation of all obtained data, documentation of all clinically significant findings, including quantitative data, and a description of any recognized anomalies “following CPT coding standards.

 It is feasible to save and review important photos, videotapes, or digital data later. Non-compliant echocardiogram use does not require separate reporting.

Modifier 59 may include the TEE code if the operation’s anesthesiologist is also performing another surgery. It suggests that the TEE is distinct from the anesthetic service if the anesthesiologist does not own the TEE equipment.

The technical component of the therapy will not bill as a Part B service in an inpatient or outpatient hospital environment. A “26” modifier will use for the physician’s service (professional component). 

The following zip codes are affected: CPT 93312, 93314, 93315, 93317, 93320, *93321, 93325, and 93799. According to the CPT handbook, “patients are usually stable, recuperating, or improving” when using this code.

The modifiers used for TTEE CPT Code are 26 & 59.

TEE CPT Code Reimbursement

Medicare does not cover 3D TEE if you are an outpatient at a hospital. In reality, including payment is part of the standard operating practice. However, for Medicare to decide the appropriate rates in the future, hospitals must continue developing and reporting on these services. 

Documenting these services is also required to maintain private payer payments (who may separately reimburse). 3D codes may offer in addition to the standard echocardiography operation codes. Take note of this (e.g., 93306)

CPT 93318 Example

If the physician fails to document or disclose their high-risk individuals, TEE monitoring ventricular function can supplement hemodynamic data. When utilized for therapeutic purposes, maintaining track of changes in heart volume and global and local contractility might be beneficial.

Routine use is not advised even for cardiopulmonary bypass or valvular surgery patients. Before mitral valvuloplasty, TEE is used to check for left atrial thrombi.

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