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Wiki Intra-Operative TEE with bypass

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danilyn

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North Canton, OH
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Hello!

I am having some trouble getting a straight answer for this question... Please help!!

Can i bill a intra-operative TEE (93318/26) with a CABG or AVR/MVR surgery?? It keeps kicking out in our edits. Wants a 59 modifier possibly?? Our surgeons usually perform this right in the beginning before the bulk of the surgery begins to check the valves etc.... Would that be considered a medical necessity?? Is it included in the main surgery??
 
The Society of Thoracic Surgeons has advised that you can bill for an intraop TEE if the following conditions are met:

1. The surgeon must supervise the entire procedure
2. Surgeon must separately document complete evaluation, not just "intraoperative TEE performed," and include indication
3. Ensure that no other professional billing (ie: cardiology) over-reading occurs.

They also said in most instances you would use 93314-26 for adults, 93316-26 for congenital.

My surgeons never separately document the TEE eval so I never bill for this.

Lisi, CPC
eharkler@nmh.org
 
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