Anesthesia Coding Alert

Question: One of our CRNAs wants to bill 93318 for a TEE (transesophageal echocardiography) procedure; another CRNA says that’s incorrect because he’s only placing the probe. My instinct is to go with 93313 but in what case would I use 93318?

Nevada Subscriber

Answer: The CRNA (or other anesthesia provider) needs to clarify exactly what service is being provided before you can decide which code to use. You currently have four options for TEE:

• 93312 (Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report)
• 93313 (… placement of transesophageal probe only)
• 93314 (… image acquisition, interpretation and report only)
• 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).

In most situations, code 93313 best represents the service they are providing if the CRNA is only placing the probe. Carefully check the documentation and ask the provider before filing the claim if you’re uncertain.