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Transesophageal echocardiography (TEE) is a specialized imaging procedure that utilizes a high-frequency ultrasound transducer, which is mounted on the tip of a flexible tube known as a probe. This probe is carefully inserted through the mouth and advanced into the esophagus, allowing it to be positioned directly behind the heart. The primary function of the transducer is to emit ultrasound waves directed towards the heart. These sound waves bounce back to the transducer after hitting the heart structures, and a computer processes these reflections to create detailed images of the heart, which are displayed on a video monitor. TEE is particularly valuable because it provides real-time ultrasound scanning, enabling the visualization of both the two-dimensional structure of the heart and its dynamic movements as they occur. During the procedure, multiple views of the heart are obtained by adjusting the position of the transducer within the esophagus, facilitating a thorough evaluation of the heart's anatomy and function. This includes assessment of the left and right chambers, the heart valves, the pericardium, and other critical structures such as the aorta, pulmonary vessels, and the vena cava. Additionally, selective M-mode recording, also referred to as T-M mode, can be utilized to provide specific time-motion information from a stationary ultrasound beam, which is superimposed on the 2D images. In this mode, depth is represented along the vertical axis while time is displayed on the horizontal axis, making it particularly useful for precise cardiac measurements, including septal wall thickness and valve timing. It is important to note that CPT® Code 93313 is specifically designated for instances where only the placement of the transesophageal probe is performed, without the accompanying image acquisition or written report of findings. In contrast, CPT® Code 93312 should be used when the physician conducts the probe placement, captures images, and provides a written report. CPT® Code 93314 is applicable when only the image acquisition and report are completed, highlighting the distinct components of the TEE procedure and their corresponding coding requirements.
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The transesophageal echocardiography (TEE) procedure is indicated for various clinical scenarios where detailed visualization of cardiac structures is necessary. The following conditions may warrant the use of TEE:
The transesophageal echocardiography procedure involves several key steps to ensure accurate placement of the probe and effective imaging of the heart. The following procedural steps are typically followed:
After the transesophageal echocardiography procedure, the patient is monitored as the sedation wears off. It is common for patients to experience a sore throat or mild discomfort due to the probe insertion, which typically resolves shortly after the procedure. Patients are advised to refrain from eating or drinking until they have fully recovered from sedation and can swallow safely. Follow-up instructions may include monitoring for any unusual symptoms and scheduling a follow-up appointment to discuss the results of the echocardiography. If any complications arise, such as difficulty swallowing or persistent pain, patients are instructed to contact their healthcare provider promptly.
| Short Descr | ECHO TRANSESOPHAGEAL | Medium Descr | ECHO R-T 2D W/PROBE PLACEMENT ONLY | Long Descr | Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 03 - Procedure must be performed under the personal supervision of physician. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | I3C - Echography/ultrasonography - heart | MUE | 1 | CCS Clinical Classification | 193 - Diagnostic ultrasound of heart (echocardiogram) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GC | This service has been performed in part by a resident under the direction of a teaching physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 73 | Discontinued out-patient hospital/ambulatory surgery center (asc) procedure prior to the administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient's surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but prior to the administration of anesthesia (local, regional block(s) or general). under these circumstances, the intended service that is prepared for but cancelled can be reported by its usual procedure number and the addition of modifier 73. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53. | 74 | Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2009-01-01 | Changed | Code description changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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