Cardiology Coding Alert
Dot the Modifier, Cross the TEE
Question: Medicare denied our claim, stating the place of service was invalid. Our cardiologist performed 93312 in the hospital, so we billed 93312-26. Is this something new? I thought when performed in the office you use 93312 or when done in a hospital setting you use 93312-26?
Tennessee Subscriber
Answer: You are correct. You should report 93312 (Echocardiography, transesophageal, real time with image documentation [2D] [with or without M-mode recording]; including probe placement, image acquisition, interpretation and report) with modifier 26 (Professional component) when the cardiologist performs a transesophageal echocardiography (TEE) at the hospital.
Most cardiologists will perform these procedures in the inpatient setting. Best bet: You should check to make sure that your place of service is listed as "21," which stands for inpatient hospital setting. Your payer may have edits set up to deny any TEEs performed in the outpatient setting (place of service "22").
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