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Transesophageal echocardiography (TEE) is a specialized imaging technique used to evaluate congenital cardiac anomalies. This procedure involves the use of a miniature high-frequency ultrasound transducer that is mounted on the tip of a flexible tube, or probe. The probe is carefully passed through the patient's mouth and advanced into the esophagus, where it is positioned behind the heart. This unique positioning allows the transducer to direct ultrasound waves directly into the heart, providing a clearer and more detailed view than traditional echocardiography methods. The sound waves emitted by the transducer bounce off the heart structures and are reflected back to the transducer. A computer then processes these sound waves and converts them into real-time images of the heart, which are displayed on a video screen. TEE is particularly beneficial for obtaining comprehensive evaluations of the heart's anatomy and function, as it allows for multiple views by manipulating the transducer within the esophagus. This enables healthcare professionals to assess the left and right chambers of the heart, the valves, the pericardium, and other critical structures such as the aorta, pulmonary vessels, and vena cava. Additionally, TEE employs selective M-mode recording, also referred to as T-M mode, which provides specific time-motion information from a stationary beam superimposed on the two-dimensional image. 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 93317 is specifically designated for instances where only image acquisition and a written report of findings are performed, without the inclusion of probe placement or image acquisition by the physician. For procedures involving probe placement and image acquisition, CPT® Code 93315 should be used, while CPT® Code 93316 is applicable when only the transesophageal probe placement is conducted.
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The transesophageal echocardiography (TEE) procedure is indicated for patients with congenital cardiac anomalies. This imaging technique is particularly useful in situations where a detailed assessment of the heart's structure and function is required, especially when traditional echocardiography may not provide sufficient clarity or detail. The following conditions may warrant the use of TEE:
The transesophageal echocardiography procedure involves several key steps to ensure accurate image acquisition and interpretation. The following procedural steps outline the process:
After the transesophageal echocardiography procedure, the patient is monitored for any immediate complications, such as discomfort or difficulty swallowing. It is common for patients to experience a sore throat following the procedure due to the probe's insertion. Patients are typically advised to refrain from eating or drinking until the effects of sedation have worn off and they can swallow safely. The healthcare provider will review the findings from the echocardiography report with the patient and discuss any necessary follow-up care or further diagnostic testing that may be required based on the results. Overall, the recovery period is generally brief, and most patients can resume normal activities shortly after the procedure, barring any specific instructions from their healthcare provider.
| Short Descr | ECHO TRANSESOPHAGEAL | Medium Descr | ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT | Long Descr | Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | 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 | 09 - Concept does not apply. | 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 | Items and Services Packaged into APC Rates | 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) |
This is a primary code that can be used with these additional add-on codes.
| 93319 | Add-on Code Resequenced Code MPFS Status: Active Code APC N 3D echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular septum) and function, when performed (List separately in addition to code for echocardiographic imaging) | 93320 | Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); complete | 93321 | Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (List separately in addition to codes for echocardiographic imaging); follow-up or limited study (List separately in addition to codes for echocardiographic imaging) | 93325 | Addon Code MPFS Status: Active Code APC N PUB 100 CPT Assistant Article Doppler echocardiography color flow velocity mapping (List separately in addition to codes for echocardiography) |
| 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. | 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. | 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. | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 1997-01-01 | Added | First appearance in code book in 1997. |
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