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Transesophageal echocardiography (TEE) is a specialized imaging technique that employs high-frequency sound waves to create detailed images of the heart and great vessels. This procedure involves the insertion of a flexible probe with a transducer tip into the esophagus, which is anatomically positioned directly behind the heart. The transducer emits sound waves that bounce off the heart structures and return to the computer, generating real-time images that provide critical insights into cardiac anatomy and function. TEE is particularly valuable for visualizing various heart components, including the aorta, pulmonary artery, heart valves, both atria, atrial septum, left atrial appendage, and coronary arteries. The images produced by TEE allow for the assessment of heart size, wall thickness, and overall pumping efficiency. Additionally, TEE is instrumental in identifying abnormal tissue surrounding heart valves, which may indicate conditions such as infection, tumors, regurgitation, or stenosis. It is also effective in detecting tears or dissections of the aorta. TEE can be utilized preoperatively to evaluate and diagnose cardiac conditions, as well as intra-procedurally during transcatheter interventions aimed at repairing heart valves, vessels, and septal defects. The procedure can incorporate various echocardiographic techniques, including M-mode ultrasound for measuring heart structure and wall thickness, Doppler echocardiography for tracking blood flow, Color Doppler for visualizing blood flow direction, two-dimensional echocardiography for assessing heart structure and motion, and three-dimensional echocardiography for enhanced imaging depth and functional measurement during motion.
© Copyright 2025 Coding Ahead. All rights reserved.
The transesophageal echocardiography (TEE) procedure is indicated for various cardiac conditions and interventions. The following are the specific indications for performing TEE:
The transesophageal echocardiography (TEE) procedure involves several critical steps to ensure accurate imaging and guidance during cardiac interventions. The following outlines the procedural steps:
After the completion of the transesophageal echocardiography (TEE) procedure, the patient is monitored for any immediate complications related to sedation or the procedure itself. It is common for patients to experience a sore throat or mild discomfort following the removal of the probe. The healthcare team will provide post-procedure instructions, which may include dietary restrictions until the effects of sedation have worn off. The results of the TEE, including the interpretation and report, will be discussed with the patient and relevant healthcare providers to inform further management and treatment plans. Follow-up appointments may be scheduled to review findings and determine the next steps in the patient's care.
| Short Descr | ECHO TRANSESOPHAGEAL (TEE) | Medium Descr | ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN | Long Descr | Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal defect closure) (peri-and intra-procedural), real-time image acquisition and documentation, guidance with quantitative measurements, probe manipulation, interpretation, and report, including diagnostic transesophageal echocardiography and, when performed, administration of ultrasound contrast, Doppler, color flow, and 3D | 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 | 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 | ASC Payment Indicator | Packaged service/item; no separate payment made. | Berenson-Eggers TOS (BETOS) | I3C - Echography/ultrasonography - heart | MUE | 1 |
| 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. | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | GC | This service has been performed in part by a resident under the direction of a teaching physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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 | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AG | Primary physician | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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Action
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Notes
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| 2019-01-01 | Changed | Code description changed. |
| 2017-01-01 | Note | Correct typographical error of the term "transcatheter" per CPT errata dated 2017-08-02 |
| 2017-01-01 | Changed | Code description changed. |
| 2015-01-01 | Added | Added |
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