# Documentation guidelines for billing Doppler/Color Flow with TEE



## parkt3@hotmail.com (Oct 23, 2014)

Can someone please help me? I bill transesophageal echos and I know that when the provider puts in his documentation the regurg amts, stenosis etc that shows he used color flow and doppler. My question is can I bill for the color flow and doppler with just that info or does the provider have to specifically state color flow and doppler were used in the report? I have looked for CMS guidelines and could not find anything specific and get different answers from people I have asked. Would like to have written documentation if anyone can direct me? Thanks.


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## jewlz0879 (Oct 23, 2014)

While studying for the CCC they discussed this. It is my understanding that since Doppler and Color-flow essentially tell you the same thing, providers are to document (for example), "color-flow reveals severe mitral and tricuspid regurgitation." As well as for what the Doppler found. 

In Aenta's policy they address this:  

Color Doppler echocardiography is essentially 2-D Doppler echocardiography with flow encoded in color to show its direction (red is toward and blue is away from the transducer) (Beers and Berkow, 1999; Gottdiener et al, 2004).  In color flow mapping, blood flow velocity is measured along each sector line of a 2-D echocardiographic image and is displayed as color coded pixels.  Color flow Doppler is most useful for assessing valves for regurgitation and stenosis, detecting the presence of intracardiac shunts, and imaging blood flow in the heart.

2-D Doppler can assess ejection fraction. 

Among functional indications, color Doppler was considered most useful for evaluating the site of right-to-left and left-to-right shunts (Antman et al, 2003).  Color Doppler was also considered useful for evaluating severity of valve stenosis and valve regurgitation and evaluation of prosthetic valves.  Color Doppler was also considered to be of some use in evaluating aortic diseases.  _*Color* Doppler was considered not useful for assessment of global left ventricular systolic function (ejection fraction),_ evaluation of regional wall motion, measurement of right ventricular and pulmonary artery systolic pressures, measurement of left ventricular filling pressure, measurement of stroke volume and cardiac output, assessment of left ventricular diastolic function, and identifying ischemia and viable myocardium with exercise or pharmacological stress.

http://www.aetna.com/cpb/medical/data/1_99/0008.html


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## parkt3@hotmail.com (Oct 24, 2014)

Thank you for your help!!


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