Transesophageal Echocardiogram

Transesophageal echocardiography (TEE) is covered when medically necessary for diagnostic evaluation of specific cardiac conditions (e.g., prosthetic mitral valves, atrial arrhythmias with need to assess left atrial thrombus, aortic dissection, intracardiac masses, mitral regurgitation, endocarditis) and when transthoracic echocardiography is inadequate. Coverage is conditional on being reasonable and necessary under Social Security Act §1862(a)(1)(A) and may be further defined by contractor Local Coverage Determinations; appropriate medical-record documentation of indication and necessity is required.

"Transesophageal echocardiography (TEE) is medically necessary for examination of prosthetic heart valves, primarily mitral prostheses."

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