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Intra-Operative TEE with bypass

  1. #1
    Question Intra-Operative TEE with bypass
    Medical Coding Books

    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??

  2. Default
    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

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