Anesthesia Coding Alert

Question: I have a CRNA who wants to bill 93318 for his part in a TEE procedure, but another CRNA says that is incorrect because he is only placing the probe. My instinct is to report 93313; in what circumstances would I use 93318?

Mississippi Subscriber

Answer: The CRNA needs to better clarify the exact service he provided before you can decide which code to report. CPT^® includes several options for coding TEE from an anesthesia perspective:

• 93312 (Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report) is used for a complete evaluation including probe placement, image acquisition, and the physician’s interpretation
• 93313 (… placement of transesophageal probe only) specifically states it is for probe placement only – not any work associated with image acquisition or interpretation
• 93314 (… image acquisition, interpretation and report only) covers image acquisition, physician interpretation, and report only – not probe placement
• 93318 (Echocardiography, transesophageal (TEE) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis) represents ongoing hemodynamic monitoring using TEE to monitor critically ill patients. It is used to monitor cardiac function during the procedure.

Tip: Sometimes if you share the descriptions, the CRNA can better choose the codes. You should also be aware that 93318 is a bundled service under the Correct Coding Initiative. Payers that follow NCCI edits will not pay separately for these monitoring services.