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2025 CPT code 93315

Transesophageal echocardiography (TEE) for congenital cardiac anomalies, including probe placement, image acquisition, interpretation, and report.

Follow all applicable CPT coding guidelines for echocardiography.Accurate documentation is crucial for proper reimbursement.

Modifiers 26 (professional component only) and TC (technical component only) may be appended as appropriate.

Medical necessity for TEE is established when there is clinical suspicion for a congenital heart anomaly, evaluation of symptoms suggestive of cardiac disease, or monitoring of known congenital heart disease.

The physician or qualified healthcare professional is responsible for proper patient preparation and sedation (if needed), probe insertion and placement, image acquisition, interpretation of the echocardiogram, documentation of findings, and generation of the report.

IMPORTANT:Should not be used with 93355.Other codes may be applicable depending on the specifics of the echocardiogram performed (e.g., additional codes for Doppler studies if performed separately).

In simple words: This test uses ultrasound to create images of the heart through a tube placed down the throat. The doctor looks at the images to check for any birth defects in the heart. The test includes taking the pictures, interpreting them and providing a written report.

Transesophageal echocardiography (TEE) is performed to visualize the heart's structures using an ultrasound probe inserted through the esophagus.The procedure includes probe placement, acquisition of two-dimensional (2D) images, M-mode imaging (when performed), Doppler and color flow studies (if done), quantitative measurements, image interpretation, and a comprehensive written report detailing findings and abnormalities.This code specifically applies when evaluating congenital cardiac anomalies.Additional imaging modalities such as 3D imaging, contrast administration, are not separately reported when performed as part of this code.Note: Code 93315 should not be reported with code 93355.

Example 1: A newborn is suspected of having a congenital heart defect. A TEE is performed to visualize the heart structures and assess for any abnormalities., An adult patient presents with symptoms suggestive of a congenital heart defect that was not detected in childhood.A TEE is used to thoroughly investigate and diagnose the potential abnormality., A pediatric patient with a known congenital heart defect requires regular monitoring of the condition's progression.Periodic TEE examinations are performed to assess the effectiveness of treatment.

The medical record must contain a detailed description of the procedure, including patient demographics, indication for the test, images obtained, measurements made, interpretation of the findings, and a final report documenting any abnormalities identified.Any pre-procedure medications, anesthesia, and any post-procedure complications should also be documented.

** The use of ultrasound contrast, Doppler, color flow, and 3D imaging are included in this code and should not be billed separately.

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