Cardiology Coding Alert

Question: Can you tell me how 93318, the new TEE code in CPT 2001, is different from the other TEE codes?

Oklahoma Subscriber

Answer: Code 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) is reported when TEE is used to monitor the patient during surgery, says Sandy Fuller, CPC, a practice coder with Abilene Cardiology Consultants, a 13-physician practice in Abilene, Texas.

Unlike other echos, in which the probe is placed and then removed after imaging and recording are performed, the 93318 TEE probe remains in position throughout the surgery. This code may be appropriately billed when TEE is used continuously to monitor complex surgeries such as mitral valve repair. If the cardiologist guides the imaging and interprets the TEE study, 93318-26 (professional component) should be billed.

In the 2001 HCFA fee schedule, 93318 includes a status code of C, which means individual carriers will establish their own relative value units and payment amount for the procedure, generally on a case-by-case basis following review of documentation such as an operative report.

Before billing the service, contact your carrier and make sure youve read the operative report and can determine what the cardiologist actually did. Carriers want to see medical necessity when they receive a 93318 claim. Local medical review policies governing regular TEE services have a variety of coverage restrictions and ICD-9 requirements.