Anesthesia Coding Alert

Question: Can you explain to me what TEE monitoring is and how I code for it?

Washington Subscriber

Answer: Anesthesiologists sometimes use TEE (transesophageal echocardiography) for monitoring during cardiac procedures. If your provider’s documentation supports the criteria, you might be able to report 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) for the service.

There is another more comprehensive code for TEE monitoring. You can use 93355 (Echocardiography, transesophageal [TEE] for guidance of a transcatheter intracardiac or great vessel[s] structural intervention[s] [e.g.,TAVR, transcathether pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal defect closure] [peri-and intra-procedural], real-time image acquisition and documentation, guidance with quantitative measurements, probe manipulation, interpretation, and report, including diagnostic transesophageal echocardiography and, when performed, administration of ultrasound contrast, Doppler, color flow, and 3D).

Remember: Medicare does not pay for TEE monitoring. Look for documentation that shows who performed the service and fully explains the procedure and service (diagnostic, monitoring, Doppler echocardiography with or without color flow, etc.) before you attempt reimbursement.