# TEE Placement.....coding HELP PLEASE!!



## indanesthesia (Sep 16, 2009)

Ok, We have just started doing TEEs.  I have been billing anesthesia for several years now, but i keep getting denials for the TEE i have been billing.

ON this case, the patient had MVR, and my anesthesiologist is biling for the insertion of a TEE.  I am confused as to how this is billed.  Is it billed as a seperate procedure with time or what.  It looks like it should be a timed procedure. If so how does this work? I am confused and would appreciate any help. 

Thank you!


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## FractalMind (Sep 16, 2009)

sounds like TEE is an additional procedure being MVR your primary procedure, we code TEE'S 93312-26 and always get payment, MCRE may require an adt'l DX so you should check your LCD.

Erika.


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## jdrueppel (Sep 17, 2009)

indanesthesia,

The CPT code for PLACEMENT only is 93313.  It should be noted that TEEs are bundled into all ASA codes.  If placed for *diagnostic purposes *(vs monitoring purposes), per the NCCI Overview Chapter 2 and NCCI edits, this service may be unbundled with the -59 modifier.  

I also want to emphasize in order to unbundle and bill separately for the complete service TEE 93312 (26 59) it must also be diagnostic and all elements of the procedure code description must be met -- probe insertion/image acquisition/INTERPRETATION and REPORT.

Choder is correct that, if you're billing Medicare, these services are subject to LCD policies and you will want to review the covered diagnosis of your carrier's LCD, however, there are many commercial carriers that have their own TEE policies which do not follow the CMS guidelines as the ASA as clearly taken the stance that TEE evaluation services are not accounted for within the ASA base unit values.  See pages xii and 52-55 of the 2009 ASA Relative Value Guide.

Hope this helps.
Julie, CPC


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## indanesthesia (Sep 18, 2009)

Thank you so much Erika and Julie.  I am new to the TEE billing and I am lost.  Your help is very appreciated. Thanks again Have a great weekend

Amanda


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