Tariff 2106 Transesophageal Echocardiography (TEE) may be claimed for TEE services provided and immediately following certain surgical services. The full description is as follows:
“Intra-Operative/Peri-Operative Comprehensive Transesophageal Echocardiography (TEE) study includes setup and patient preparation, cardiac monitoring and re-evaluation, 2‑D study, colour flow mapping, Doppler study and M‑mode, interpretation and reporting per case.”
- This tariff shall only be claimed when provided by qualified anesthesiologists in relation to cardiac surgery, spine surgery, neurosurgery, vascular surgery or trauma surgery.
- Claims must include a relevant diagnostic code for the cardiac condition.
- Make only one claim per patient per operation
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 primary surgical procedure indication, include an ICD code indicating the cardiac condition with the TEE service claim.
- Payment for Tariff 2106 is 100% in addition to any other claims for anesthetic services for the patient that day.
- It is possible to claim a second TEE service for the same patient on the same day, provided the patient underwent a second operation.
- Suppose a TEE is performed by the anesthesiologist while the patient is in recovery from open-heart surgery. Bleeding is detected. The patient returns to the OR for a post-operative hemorrhage control procedure and the same anesthesiologist then performs a second TEE to confirm that there is no further bleeding.
- In this situation, avoid the rejection of your claim as a duplicate by adding a remark such as “second surgery performed.” 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.
- Claim Tariff 2106 when the service is provided during the intra-operative or immediate post-operative period. Once the anesthesiologist has discharged the care of the patient to the ICU/ step-down unit, Tariff 2106 may not be claimed. The physician responsible for the patient’s post-operative care should consult the hospital’s echocardiography service if TEE services are required.
April 8, 2021