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Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only

CPT4 code

Name of the Procedure:

Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only

Summary

Transesophageal echocardiography (TEE) is an imaging test that uses sound waves to create detailed pictures of the heart. It's done with a special probe that is inserted into the esophagus (the tube connecting the throat to the stomach), giving a close-up view of the heart's structures.

Purpose

TEE is used to detect and evaluate various heart conditions, such as valve diseases, heart function, blood clots, tumors, and infections. The goal is to provide detailed images that help in diagnosing and planning the treatment of heart problems.

Indications

  • Unexplained chest pain or discomfort
  • Suspected heart valve issues
  • Infections affecting the heart valves (endocarditis)
  • Blood clots in the heart
  • Congenital heart conditions
  • Pre-surgical assessment for heart surgery

Preparation

  • Fasting for at least 6 hours before the procedure
  • Medication adjustments as advised by your doctor
  • Pre-procedure tests like blood work or standard echocardiogram

Procedure Description

  1. The patient is sedated to ensure comfort.
  2. The throat is numbed to suppress the gag reflex.
  3. A flexible probe is gently guided down the throat into the esophagus.
  4. Real-time 2D images of the heart's structures are captured, with or without M-mode recording, which measures heart function.
  5. The probe is then carefully removed.

Duration

Typically takes about 30-60 minutes.

Setting

Performed in a hospital or outpatient clinic, typically in a procedure room equipped for echocardiography.

Personnel

  • Cardiologist or specially trained physician
  • Nurse or echocardiography technician
  • Anesthesiologist or sedation nurse

Risks and Complications

  • Mild sore throat or discomfort
  • Risk of esophageal perforation (very rare)
  • Adverse reactions to sedation
  • Temporary hoarseness or voice changes
  • Vomiting or reaction to the numbing medication

Benefits

Provides highly detailed images of the heart, allowing for accurate diagnosis and treatment planning. Often reveals issues that other imaging tests may miss.

Recovery

  • Short observation period post-procedure until sedation wears off
  • Avoid eating or drinking until the numbness in the throat subsides
  • Rest for the remainder of the day
  • Follow-up appointment to discuss results

Alternatives

  • Transthoracic echocardiography (TTE)
  • CT or MRI scans of the heart
  • Cardiac catheterization

Patient Experience

During the procedure, the patient might feel slight pressure in the throat when the probe is inserted. Post-procedure, some throat soreness is common. Pain relief and comfort measures are provided to manage any discomfort.

Medical Policies and Guidelines for Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); placement of transesophageal probe only

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