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TEE Codes Bundled In April 1 Revision April 7, 2003 - Effective April 1, 2003, anesthesia providers will no longer be reimbursed separately for intraoperative transesophageal echocardiography (TEE). The Centers for Medicare and Medicaid Services (CMS) made changes in its Correct Coding Initiative (CCI) Version 9.1 that effectively bundles TEE with anesthesia service codes or other CPT codes. CCI is the software CMS uses to edit coding in incoming claims. Previously, TEE codes could be unbundled with modifier –59, indicating “separate service” where appropriate. The narrative section of the CCI states that the diagnostic use of TEE is payable under the –59 modifier. However, CCI Version 9.1 globally resets the modifier to –0 on the edits, indicating that Medicare, and possibly other third party insurance carriers, will no longer reimburse for TEE. The American Society of Anesthesiologists (ASA) has been lobbying to make TEE a separately coded procedure, due to its specialized use in diagnosing and monitoring perioperative uncertainties in heart patients, regardless of the surgical procedure. While it is a relatively new procedure, the ASA considers TEE to have “important advantages over other techniques.” According to the ASA’s statement on TEE, “The indication for TEE is usually based on the individual patient’s condition rather than the specific surgical procedure. This is why this procedure should be considered an additional service that is not part of the usual anesthetic work.” The TEE codes affected are: 93312 (echocardiography, transesophageal), 93313 (placement of probe only), 93315 (transesophageal echocardiography, congenital cardiac anomalies), and 93316 (transesophageal echocardiography, congenital cardiac anomalies; placement of probe only).
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