Anesthesia Coding Alert

Question: Our physician provided anesthesia during a transesophageal echocardiography (TEE) procedure with probe placement. What code do I report?

New Hampshire Subscriber

Answer: It looks like your anesthesiologist is involved with 93312 (Echocardiography, transesophageal, real-time with image documentation [2D] [with or without M-moderecording]; including probe placement, image acquisition, interpretation and report). The anesthesia crosswalk for 93312 and the subsequent TEE codes is 01922 (Anesthesia for non-invasive imaging or radiation therapy).

Keep these tips in mind when you code for TEE:

• When you report intraoperative TEE by an anesthesiologist, you should usually include modifier 59 (Distinct procedural service). This applies to TEE codes 93312-93317, +93320, +93325, and 93799 (Unlisted cardiovascular procedure or service).
• When your anesthesiologist performs the service in a hospital inpatient/outpatient setting, the technical component is considered a Part A service and is not billable to Part B. Report the service with modifier 26 (Professional component). This applies to codes 93312, 93314, 93315, 93317, 93320, 93325, and 93799.
• When your anesthesiologist places the probe and does not provide a written report, submit 93313 (... placement of transesophageal probe only).
• Some payers, including Medicare, will deny TEE for routine intraoperative monitoring (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) as not medically necessary.