What are the ICD-10-PCS guidelines?
Transesophageal Echocardiogram Procedure
What are the warning signs of clogged arteries?
Cardioversion CPT code 92960 & 92961 Coding tips for Coders.
CPT code 93318 – Echocardiography, transesophageal (TEE) for monitoring purposes is used to describe intraoperative TEE that is performed to monitor the patient's cardiovascular function during surgery or another intervention.
This is a procedure where a special tube which houses a small ultrasound probe is placed in your mouth and passed down your esophagus. This allows your cardiologist to obtain ultrasound images of your heart from inside your body.
A traditional echocardiogram is done by putting the transducer on the surface of the chest. This is called a transthoracic echocardiogram. A transesophageal echocardiogram is done by inserting a probe with a transducer down the esophagus.
Answer: Absolutely, yes. There is a specific CPT code, 92960, for such cardioversions. There are no separate codes or modifiers for using paddles or hands-free, and there are no special codes or modifiers for biphasic cardioversion. CPT code 92960 is for elective cardioversion, not defibrillation.
Article - Billing and Coding: Transesophageal Echocardiography (TEE) (A52868)
The correct CPT code for the complete procedure is 93312.
The use of TEE may allow cardioversion to be done earlier, may decrease the risk for embolism associated with cardioversion, and may be associated with less clinical instability than conventional therapy.
Transesophageal echocardiography (TEE) can reliably detect left atrial and left atrial appendage thrombi. This procedure could be used to risk stratify patients before cardioversion.
TEE is considered more sensitive for the detection of major cardiac sources of emboli such as left atrial thrombus, aortic atheroma, valve abnormalities, atrial septal abnormalities and cardiac tumours. TTE is more suited for the visualization of left ventricular thrombus.
A transesophageal echocardiogram (TEE) is a special type of echocardiogram. It is usually done when your doctor wants to look more closely at your heart to see if it could be producing blood clots. Like an echocardiogram, the TEE uses high-frequency sound waves (ultrasound) to examine the structures of the heart.
There are several different ways an echocardiogram can be carried out, but most people will have a transthoracic echocardiogram (TTE).
The list of ICD-10 codes for this secondary diagnosis will be found in the LCD for Transthoracic Echocardiography, L34338, under the list of payable ICD-10 codes for CPT codes 93303 and 93304, and the list of payable ICD-10 codes for CPT codes 93306, 93307 and 93308.
TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; PLACEMENT OF TRANSESOPHAGEAL PROBE ONLY
TEE has a particularly high degree of sensitivity and specificity for aortic dissection. TEE is the technique that is indicated in examination of the entire aorta, especially in emergency situations.
Spectral Doppler echocardiography and Doppler color flow-velocity mapping (93320, 93321, 93325) may be necessary in addition to an echocardiogram when the examination could contribute significant information to the patient's condition or treatment plan (For dates of service on or after 01/01/2009, code 93306 should be used when Doppler is combined with a complete echocardiogram). Typically, Doppler is indicated in the evaluation of some heart murmurs, valvular problems, shunts, suspected congenital heart disease, complications of myocardial infarction, or cardiomyopathy. Doppler should be medically necessary for the evaluation and management of the patient.
The use of the Doppler is inherent in the ultrasonic cardiac evaluation. However, if the test reports fail to document the use of this technique to assess these structures and function (e.g., measurement of valvular insufficiency or stenosis, myocardial diastolic function, etc. as described by the ASE), or if the medical records fail to document that the examination was "clinically necessary" (e.g., follow-up of pericardial effusion size) then the Doppler portion of the test may be considered medically unnecessary and denied.
CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Refer to Local Coverage Determination (LCD) L35016, Transesophageal Echocardiography (TEE)
Refer to the Novitas Local Coverage Determination (LCD) L35016, Transesophageal Echocardiography (TEE), for reasonable and necessary requirements. The Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code (s) may be subject to National Correct Coding Initiative (NCCI) edits.
It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim (s) submitted.
All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
procedure code and description 93312- Echo transesophageal - average fee payment- $300 - $ 320 CPT code 93312 - Echocardiography, transesophageal, real time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report describes the entire TEE service when it is performed by…
Echocardiography is a non-invasive technique in which pulsed high-frequency sound waves are used to visualize the contours, movements and dimensions of cardiac structures. Ultrahigh frequency sound waves are directed toward and reflected by cardiovascular structures. Reflected echoes are translated into electrical impulses for display on a monitor and for recording and storage on either videotape or digital recording.
Suspected Cardiac Thrombi and Emboli:Historical estimates place the incidence of a cardiac source of emboli at between 15 and 30 percent. Selective study of these patient cohorts by TTEdetects a potential cardiac source in 10 percent. In general, TTEcan reliably diagnose or exclude a ventricular locus of potentially embolic material. In patients with cardiac pathology associated with a high incidence of thromboembolic (valvular heart disease, arrhythmias – especially atrial fibrillation, cardiomyopathies, other causes of ventricular dysfunction) the incremental information provided by TEEshould be of therapeutic relevance before the patient is subjected to TEE. Routine TEEto search for a cardiac source of embolization is not considered necessary. In younger stroke patients with a normalTTEand neurologic workup, TEEis appropriately considered. A key decisional factor should be whether TEEfindings may substantively alter therapy and clinical outcome. It merits emphasis that a negative examination (TTEor TEE) does not exclude a cardiac embolus, and the finding of thrombus or vegetation does not establish a cardiac embolic source.
For services on or after May 22, 2007, CMS national policy permits Medicare coverage for monitoring cardiac output by transesophageal Doppler for ventilated patients in the ICU and operative patients with a need for intraoperative fluid optimization.
Medicare payment for the professional component of intraoperative TEE is justified for instances in which intraoperative echocardiography is an adjunct to optimal performance of a surgical procedure or for a specific diagnostic reason (e.g., proper valve placement, guiding of the placement of a device to close an atrial septal defect, evaluation of mitral balloon valvuloplasty, etc.). Intraoperative echocardiographic services must include a complete interpretation and written report by the performing physician, and images obtained must be stored in the same manner as other echocardiographic services to warrant separate payment.
Transesophageal echocardiogram will be considered medically necessary in any of the following circumstances (see Covered ICD-10 Codes):