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Full Services for TEE Are Payable Full by James Smith
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Full Services for TEE Are Payable Full |
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Health
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Beginning July 1, Medicare will again reimburse anesthesiologists' services for some transesophageal echocardiography (TEE) procedures performed during an anesthetic. The caveat is that it must be a diagnostic TEE procedure conducted with an anesthetic. Most TEE procedures are diagnostic, used to establish myocardial ischemia or cardiac valve function. This change modifies the National Correct Coding Initiative (NCCI) edits implemented April 1. Those edits ( NCCI Edits 9.1) changed the status indicators for most TEE procedure codes and kept anesthesiologists from appending modifier -59 (Distinct procedural service) to receive payment for services. Four TEE codes will be reinstated with modifier indicator "1" status, which means anesthesiologists can again report their services with modifier -59: 93312 Echocardiography, transesophageal, real time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report
93313 placement of transesophageal probe only 93315 Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report 93316 placement of transesophageal probe only. When NCCI 9.1 bundled the TEE services with anesthesia, the American Society of Anesthesiologists (ASA) began working to have this changed so anesthesiologists could continue billing for their involvement in the procedure. According to a response letter from CMS to the ASA, "CMS will modify these edits [from NCCI 9.1] to allow use of NCCI associated modifiers if the TEE procedure is for diagnostic purposes. As you know, in the past CMS has allowed providers to report 'image acquisition, interpretation and report only' ( CPT codes 93314, Echocardiography, transesophageal, real time with image documentation [2D] [with or without M-mode recording]; image acquisition, interpretation and report only, and 93317, Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only) when performed for diagnostic purposes during anesthesia. CMS has decided to also allow providers to bill for the probe placement when a diagnostic TEE is performed during anesthesia. CMS realizes that when a provider inserts the TEE probe the provider does not know whether it will be utilized solely for monitoring or also for a diagnostic TEE. If the TEE probe is used solely for monitoring, its placement is not separately reportable. However, if the patient requires a diagnostic TEE by the anesthesiologist, both the placement of the probe and the interpretation may be reported." The letter also reminds providers that codes 93312-93317 should not be reported for TEE for
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