Tariff 2106 Transesophageal Echocardiography (TEE) may be claimed for TEE services provided and immedately following certain surgical services. The full description is as follows:
||Intra-Operative/Peri-Operative Comprehensive Transesophageal Echocardiography (TEE) study including setup and patient preparation, cardiac monitoring and re-evaluation, 2-D study, color flow mapping, Doppler study and M-mode, interpretation and reporting per case.
- This tariff shall only be claimed when provided by qualified anesthetists in relation to cardiac surgery, spine surgery, neurosurgery, vascular surgery or trauma surgery.
- Claims must include a relevant diagnostic code for the cardiac condition.
- Only one (1) claim per patient per operation may be made
As per note 2), tariff 2106 may be claimed when the primary surgical procedure is related to cardiac, spine, neurosurgery, vascular surgery or trauma surgery.
- Regardless of the indication for the primary surgical procedure, an ICD code indicating the cardiac condition must be included with the claim for the TEE service.
- Tariff 2106 shall be paid at 100% in addition to the payment for any other anesthetic services that may be claimed for the patient on that day.
- A second TEE service may be claimed for the same patient on the same day provided that the patient underwent a second operation.
- E.g., a TEE is performed by the anesthetist while the patient is in recovery from open heart surgery. Bleeding is detected and the patient returned to OR for a post-operative hemorrhage control procedure. A second TEE is then performed by the same anesthetist to confirm that there is no further bleeding.
- In this situation it is recommended that you add a remark to your claim such as “second surgery performed” to avoid it being rejected as a duplicate claim. Both claims for tariff 2106 shall be paid at 100%. A second TEE will not be paid if the patient did not return to the OR.
- Tariff 2106 may be claimed when rendered during the intra-operative or immediate post-operative period. Once the anesthetist has discharged the care of the patient to the ICU/ step-down unit, tariff 2106 may not be claimed.The physician then responsible for the patient’s post-operative care should consult the hospital’s echocardiography service if TEE services are required.
Updated: November 2016