Interventional Transesophageal Echocardiography: Background and Coding Review

Structural Heart Intervention (SHI) is a rapidly evolving field that requires a multidisciplinary team of experts to achieve procedural success. The echocardiographer is a key member of this team, applying advanced transesophageal echocardiography (TEE) imaging to aid in patient evaluation and device selection. The echocardiographer provides real-time guidance of device placement during an SHI procedure, evaluating the immediate outcome of the procedure. The echocardiographer also identifies any procedural complication and assists in guiding its resolution. Such TEE guidance is critical for complex atrial septal defect closure, left atrial appendage occlusion, transcatheter repair of paravalvular regurgitation, transcatheter edge to edge mitral valve repair (TEER)
and transcatheter mitral valve replacement, transcatheter tricuspid valve repair, percutaneous closure of ventricular septal defects, and — in some cases — transcatheter aortic valve replacement (TAVR). The specific work of the echocardiographer during an SHI procedure, reflecting procedural time and intensity, is represented by Current Procedural Terminology (CPT) code 93355.